Demography and clinical course of ulcerative colitis in Arabs - A study based on the Montreal classification

Iqbal Siddique, Waleed Alazmi, Jaber Al-Ali, J. Craig Longenecker, Ahmad Al-Fadli, Fuad Hasan, Anjum Memon

Research output: Contribution to journalArticle

Abstract

Objective. Ulcerative colitis (UC) is generally considered a disease of the Caucasian populations in developed countries, but its incidence is increasing rapidly in many developing countries, including the Middle East. The objective of this study was to determine the clinical epidemiology of UC in Arabs. Material and methods. This cross-sectional medical record-based descriptive study collected sociodemographic and clinical information on 182 Arab patients with UC in Kuwait. Age at diagnosis, extent and severity of disease were determined according to the Montreal classification. Results. Among the 182 patients, 91 (50.0%) were males. The median age at diagnosis was 28.5 years. Family history of UC was reported by 26 (14.3%) patients. The extent of the disease was limited to the rectum in 34 (18.7%) patients, left sided in 67 (36.8%) and pan colitis in 81 (44.5%). At the time of inclusion in the study, 127 (69.8%) patients were in clinical remission, 53 (29.1%) had mild-to-moderate disease and 2 (1.1%) had severe colitis. Younger age at diagnosis and non-smoking were associated with more extensive colitis. The majority of patients were treated with mesalamine, steroids and immunomodulators, while biologic therapy and surgery were needed in 5% and 4% of the patients, respectively. Conclusions. UC presents more commonly at younger age among Arabs in Kuwait. Extensive disease at presentation is associated with younger age at diagnosis and absence of tobacco smoking. There also appears to be less need for surgery and biologic therapy for the disease in this population.

Original languageEnglish (US)
Pages (from-to)1432-1440
Number of pages9
JournalScandinavian Journal of Gastroenterology
Volume49
Issue number12
DOIs
StatePublished - Dec 1 2014
Externally publishedYes

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Ulcerative Colitis
Demography
Colitis
Kuwait
Biological Therapy
Mesalamine
Middle East
Immunologic Factors
Developed Countries
Rectum
Population
Developing Countries
Medical Records
Epidemiology
Smoking
Steroids
Incidence

Keywords

  • Arab
  • Inflammatory bowel disease
  • Kuwait
  • Montreal classification
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

Cite this

Demography and clinical course of ulcerative colitis in Arabs - A study based on the Montreal classification. / Siddique, Iqbal; Alazmi, Waleed; Al-Ali, Jaber; Longenecker, J. Craig; Al-Fadli, Ahmad; Hasan, Fuad; Memon, Anjum.

In: Scandinavian Journal of Gastroenterology, Vol. 49, No. 12, 01.12.2014, p. 1432-1440.

Research output: Contribution to journalArticle

Siddique, Iqbal ; Alazmi, Waleed ; Al-Ali, Jaber ; Longenecker, J. Craig ; Al-Fadli, Ahmad ; Hasan, Fuad ; Memon, Anjum. / Demography and clinical course of ulcerative colitis in Arabs - A study based on the Montreal classification. In: Scandinavian Journal of Gastroenterology. 2014 ; Vol. 49, No. 12. pp. 1432-1440.
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abstract = "Objective. Ulcerative colitis (UC) is generally considered a disease of the Caucasian populations in developed countries, but its incidence is increasing rapidly in many developing countries, including the Middle East. The objective of this study was to determine the clinical epidemiology of UC in Arabs. Material and methods. This cross-sectional medical record-based descriptive study collected sociodemographic and clinical information on 182 Arab patients with UC in Kuwait. Age at diagnosis, extent and severity of disease were determined according to the Montreal classification. Results. Among the 182 patients, 91 (50.0{\%}) were males. The median age at diagnosis was 28.5 years. Family history of UC was reported by 26 (14.3{\%}) patients. The extent of the disease was limited to the rectum in 34 (18.7{\%}) patients, left sided in 67 (36.8{\%}) and pan colitis in 81 (44.5{\%}). At the time of inclusion in the study, 127 (69.8{\%}) patients were in clinical remission, 53 (29.1{\%}) had mild-to-moderate disease and 2 (1.1{\%}) had severe colitis. Younger age at diagnosis and non-smoking were associated with more extensive colitis. The majority of patients were treated with mesalamine, steroids and immunomodulators, while biologic therapy and surgery were needed in 5{\%} and 4{\%} of the patients, respectively. Conclusions. UC presents more commonly at younger age among Arabs in Kuwait. Extensive disease at presentation is associated with younger age at diagnosis and absence of tobacco smoking. There also appears to be less need for surgery and biologic therapy for the disease in this population.",
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