SUMMARY The effect of topical disodium cromoglycate (DSCG) has been examined in 30 patients with chronic active proctitis using a double-blind crossover trial. Each treatment period was four weeks and patients were given DSCG 200 mg by enema twice daily and 100 mg orally three times each day. Twenty-six patients completed the trial successfully, 14 responded to DSCG treatment, two improved with placebo, and 10 responded to neither.Patients who responded to DSCG had significantly more eosinophils in their rectal biopsies than those who failed to respond and in some instances the counts were very high. The findings support the hypothesis that an allergic reaction is important in the pathogenesis of proctitis.Disodium cromoglycate (DSCG) is of proven clinical value in allergic bronchial asthma where it is thought to reduce the degranulation of mast cells in bronchial mucosa (Pepys, Hargreave, Chan, and McCarthy, 1968). Chronic proctitis is an inflammatory condition of unknown aetiology affecting the rectal mucosa. In a related condition, ulcerative proctocolitis, mast cell degranulation is a common feature in rectal biopsies (Bercovitz and Sommers, 1966). It is therefore pertinent to examine whether DSCG, if given topically, would have a beneficial effect in patients with proctitis. Proctitis is a particularly suitable condition to examine because in addition to recording any symptomatic response, the rectal mucosa can be both inspected and biopsied directly. A randomized, double-blind crossover trial was designed to examine the effect of this compound in a group of patients with chronic proctitis. Methods PATIENTSThirty patients with chronic proctitis were included in the trial but four were subsequently withdrawn. All had active symptoms which included rectal bleeding, the passage of mucus, and a change in bowel habit, usually with increased frequency. In all the rectal mucosa was abnormal on sigmoidoscopy. The subsequent details refer to the 26 patients

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Summary The fertility of 70 men with Crohn's disease and a group of age matched controls were compared. Crohn's disease was associated with a significant reduction in family size independent of steroid or sulphasalazine treatment.

The prevalence of Crohn’s disease in the Jewish population of south-east Wales was established by a postal survey, review of case notes and a survey of Jewish congregations in the three synagogues of the area. The prevalence of Crohn’s disease had been established in various earlier studies at 52/105. Seven Jewish patients were identified amongst a population of between 1,750 and 2,500. The prevalence ranged from 280 to 400/10⁵ (95% confidence interval 120–862/10⁵). There was no significant difference in prevalence between orthodox and reformed Jews. Jewish people are at a relative risk of developing Crohn’s disease of 5.4–7.7 (95% confidence interval 2.3–17.2, p < 0.001), but the role of diet is yet to be established.

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