Clinical features and biomarkers associated with ulcerative colitis: A systematic review and meta-analysis

doi:10.3748/wjg.123374

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World Journal of Gastroenterology

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1007-9327

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Meta-Analysis

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Dec 14, 2026; 32(46): 123374
Published online Dec 14, 2026. doi: 10.3748/wjg.123374

Table 2 Meta-analysis of gastrointestinal manifestations in ulcerative colitis vs controls

	Number of studies	OR (95%CI)	I² value
Diarrhea
UC compared to CD	90	2.8354 (2.1042-3.8207)	91.90%
UC compared to IC	20	3.6189 (1.9834-6.6029)	79.20%
UC compared to ITB	7	3.2938 (1.4310-7.5817)	61.40%
UC compared to IBS	1	0.8547 (0.2845-2.5672)	Ne
UC compared to IE	1	73.125 (12.0141-445.0822)	Ne
UC compared to IBD-U	8	0.7829 (0.3692-1.6600)	65.50%
UC compared to other	8	3.7437 (1.5344-9.1339)	75.30%
Abdominal pain
UC compared to CD	97	0.6813 (0.5385-0.8620)	82.20%
UC compared to IC	20	0.7049 (0.3922-1.2671)	68.80%
UC compared to ITB	7	0.3951 (0.2311-0.6755)	20.20%
UC compared to IBS	1	0.2553 (0.0657-0.9921)	Ne
UC compared to IE	2	0.8325 (0.1465-4.7294)	82.70%
UC compared to IBD-U	8	1.4172 (0.5101-3.9370)	79.30%
UC compared to other	8	0.8051 (0.3394-1.9100)	74.10%
Abdominal distension
UC compared to CD	24	0.6236 (0.4878-0.7972)	44.00%
UC compared to IC	8	0.5393 (0.1809-1.6077)	59.40%
UC compared to ITB	2	0.3423 (0.0903-1.2975)	52.70%
UC compared to IBS	1	0.0981 (0.0377-0.2553)	Ne
UC compared to IBD-U	3	0.5682 (0.2499-1.2918)	0.00%
UC compared to other	4	0.8627 (0.1881-3.9578)	80.30%
Abdominal masses
UC compared to CD	31	0.1156 (0.0567-0.2359)	62.60%
UC compared to ITB	2	0.0877 (0.0148-0.5177)	0.00%
UC compared to other	2	0.0204 (0.0025-0.1695)	0.00%
Constipation
UC compared to CD	13	0.7023 (0.4373-1.1278)	1.80%
UC compared to IC	1	0.0462 (0.0026-0.8288)	Ne
UC compared to IBD-U	2	1.6415 (0.3023-8.9145)	0.00%
UC compared to other	1	1.0548 (0.5142-2.1637)	Ne
Hematochezia
UC compared to CD	67	4.972 (3.2464-7.6149)	86.00%
UC compared to IC	20	0.2188 (0.0928-0.5157)	89.10%
UC compared to ITB	4	14.6073 (1.7111-124.7033)	84.30%
UC compared to IBS	1	1.6536 (0.7376-3.7070)	Ne
UC compared to IE	1	15.9107 (7.8763-32.1409)	Ne
UC compared to IBD-U	7	1.3433 (0.3460-5.2160)	62.90%
UC compared to other	5	10.0202 (1.9272-52.0994)	84.50%
Mucous stools
UC compared to CD	15	3.8432 (2.3049-6.4084)	74.00%
UC compared to IC	3	16.0749 (2.9795-86.7264)	0.00%
UC compared to IBS	1	0.2935 (0.1207-0.7136)	Ne
UC compared to IE	1	1.5467 (0.8513-2.8101)	Ne
UC compared to IBD-U	2	0.2084 (0.0033-13.0778)	79.00%
UC compared to other	1	5.3478 (2.1506-13.2983)	Ne
Bloody mucopurulent stools
UC compared to CD	32	13.3297 (8.2855-21.4449)	77.20%
UC compared to IC	14	20.6811 (10.9195-39.1691)	29.10%
UC compared to ITB	2	43.1424 (5.7461-323.9189)	0.00%
UC compared to IBD-U	3	0.6677 (0.1310-3.4033)	82.90%
UC compared to other	2	6.1153 (0.3181-117.5773)	72.50%
Tenesmus
UC compared to CD	35	3.7201 (2.7546-5.0238)	54.30%
UC compared to IC	10	11.5292 (4.4590-29.8098)	13.00%
UC compared to ITB	1	6.1268 (0.9247-40.5953)	Ne
UC compared to IBS	1	0.1722 (0.0732-0.4049)	Ne
UC compared to IE	1	1.6101 (0.9868-2.6270)	Ne
UC compared to IBD-U	2	0.8719 (0.4974-1.5284)	0.00%
UC compared to other	1	1.5726 (0.6142-4.0266)	Ne
Perianal fistulae
UC compared to CD	16	0.0769 (0.0438-0.1350)	25.20%
Perianal abscesses
UC compared to CD	22	0.1328 (0.0555-0.3177)	69.70%
UC compared to IBD-U	1	0.36 (0.0826-1.5684)	Ne
UGI symptoms
UC compared to CD	20	0.5823 (0.3765-0.9004)	66.80%
UC compared to IC	7	0.5417 (0.2933-1.0007)	0.00%
UC compared to IE	1	0.0344 (0.0149-0.0791)	Ne
UC compared to IBD-U	2	0.3599 (0.1611-0.8042)	0.00%
UC compared to other	2	0.6508 (0.3637-1.1643)	0.00%

UC: Ulcerative colitis; CD: Crohn’s disease; IC: Ischemic colitis; ITB: Intestinal tuberculosis; IBS: Irritable bowel syndrome; IE: Infectious enteritis; IBD-U: Inflammatory bowel disease unclassified; Other: Unspecified diseases; OR: Odds ratios; CI: Confidence intervals; UGI: Upper gastrointestinal; Ne: There is only one type of disease in the control group, or only a single study was included, precluding the assessment of heterogeneity.

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Citation: Liu K, Zhang XH, Zhou XY, Liu YX, Pan SQ, Liu TX, Russell R, Wang XH, Yao YP, Zhao XJ, Sun HY, Ju CL, Liu JP, Liu ZL. Clinical features and biomarkers associated with ulcerative colitis: A systematic review and meta-analysis. World J Gastroenterol 2026; 32(46): 123374
URL: https://www.wjgnet.com/1007-9327/full/v32/i46/123374.htm
DOI: https://dx.doi.org/10.3748/wjg.123374

Liu K, Zhang XH, Zhou XY, Liu YX, Pan SQ, Liu TX, Russell R, Wang XH, Yao YP, Zhao XJ, Sun HY, Ju CL, Liu JP, Liu ZL. Clinical features and biomarkers associated with ulcerative colitis: A systematic review and meta-analysis. World J Gastroenterol 2026; 32(46): 123374 [DOI: 10.3748/wjg.123374]

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