Published online Jan 21, 2014. doi: 10.3748/wjg.v20.i3.814
Revised: November 21, 2013
Accepted: December 3, 2013
Published online: January 21, 2014
AIM: To study the natural history, patterns and clinical characteristics of inflammatory bowel diseases (IBD) in Egypt.
METHODS: We designed a case-series study in the gastroenterology centre of the Internal Medicine department of Cairo University, which is a tertiary care referral centre in Egypt. We included all patients in whom the diagnosis of ulcerative colitis (UC) or Crohn’s disease (CD) was confirmed by clinical, laboratory, endoscopic, histological and/or radiological criteria over the 15 year period from 1995 to 2009, and we studied their sociodemographic and clinical characteristics. Endoscopic examinations were performed by 2 senior experts. This hospital centre serves patients from Cairo, as well as patients referred from all other parts of Egypt. Our centre received 24156 patients over the described time period for gastro-intestinal consultations and/or interventions.
RESULTS: A total of 157 patients with established IBD were included in this study. Of these, 135 patients were diagnosed with UC (86% of the total), and 22 patients, with CD (14% of the total). The mean ages at diagnosis were 27.3 and 29.7, respectively. Strikingly, we noticed a marked increase in the frequency of both UC and CD diagnoses during the most recent 10 years of the 15 year period studied. Regarding the gender distribution, the male:female ratio was 1:1.15 for UC and 2.6:1 for CD. The mean duration of follow up for patients with UC was 6.2 ± 5.18 years, while the mean duration of follow up for patients with CD was 5.52 ± 2.83 years. For patients with UC we found no correlation between the severity of the disease and the presence of extraintestinal manifestations. Eleven patients had surgical interventions during the studied years: 4 cases of total colectomy and 7 cases of anal surgery.
CONCLUSION: We observed a ratio of 6:1 for UC to CD in our series. The incidence of IBD seems to be rising in Egypt.
Core tip: The precise aetiology of inflammatory bowel disease (IBD) remains obscure. In our study, the ratio of patients diagnosed with ulcerative colitis (UC) to those diagnosed with Crohn’s disease (CD) was approximately 6:1. The total colectomy rate in our study was 2.9%, after a follow up period of 5-15 years, which is far lower than the rates of Western countries. We found that the characteristics of IBD in the Egyptian population were more similar to Asian and African IBD patterns. We noticed a marked increase in the frequency of UC and CD diagnoses over the past 10 years, which indicates an increasing incidence of IBD in Egypt.