The Nature of Benign Strictures in Ulcerative Colitis

Abstract

In a series of 19 examples of benign stricture of the colon in patients with chronic ulcerative colitis insufficient fibrosis was found in the resected specimens to account for the narrowing. Measurements of the various layers of the gut wall were made in both the portions involved and those not involved by stricture, and these were compared with similar measurements in resected specimens from patients with ulcerative colitis without stricture and in normal sigmoid colons. The most striking finding was that in ulcerative colitis the muscularis mucosae is hypertrophied and is in a state of contraction. In the zones of stricture the contraction appears to be so forceful that the inner circular coat of the muscularis mucosae pulls away from the outer longitudinal coat, thereby narrowing the lumen of the gut. The importance of this finding is that such strictures should be reversible.