Epidemiology and Clinical Outcomes of Inflammatory Bowel Disease: A Hospital-Based Study in Central Taiwan.

Chia-Hsi Chang,Tsung-Wei Chen,Hsiang-Chun Lai,Ken-Sheng Cheng,Chun-Lung Feng,Jen-Wei Chou

doi:10.1155/2019/4175923

Abstract

The incidence and prevalence of inflammatory bowel disease (IBD) are low but increasing in Taiwan. We aimed to investigate the epidemiology and clinical outcomes of IBD in central Taiwan. We retrospectively analyzed patients with IBD diagnosed at our hospital between January 2000 and September 2018. The diagnostic criteria were based on endoscopic and pathologic findings. Clinical characteristics, treatment regimens, and treatment outcomes were analyzed. A total of 190 patients with IBD were enrolled (80 with Crohn's disease (CD) and 110 with ulcerative colitis (UC)). The mean age at diagnosis was 38.4 years (CD: 36 years, UC: 40 years). Male patients accounted for the majority of patients (71.1%). The male-to-female ratio was 3 : 1 for CD and 2.1 : 1 for UC. Current and ever smokers accounted for 30.5% of all patients. Only 4.2% of patients had a family history of IBD. Extraintestinal manifestations (EIMs) were reported in 7.9%, and colorectal cancers (CRCs) were reported in 2.1% of all patients. In patients with CD, the ileal type was the most common disease phenotype (57.5%), and the stricturing type was the most common disease behavior (60.0%). In patients with UC, left-sided colitis was the predominant disease extent (42.7%). The seroprevalence of hepatitis B virus (HBV) was 13.3%. The incidence of perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in patients with UC was 22%. 5-Aminosalicylic acids were the preferred treatment for UC, whereas corticosteroids, immunomodulators, and biologic agents were preferred for CD. In patients with CD, the bowel resection rate was 38.8%, and the incidence of hip avascular necrosis was 3.8%. In Taiwan, patients with IBD showed a male predominance, lack of familial clustering, a higher prevalence of HBV infection, and a lower prevalence of p-ANCA, EIMs, and CRC. Moreover, a higher incidence of the ileal type with poor outcomes of CD and left-sided predominance in UC were found.

Highlights

Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic relapsing and remitting disease
In the investigation of family history of IBD in all patients, we found only 4.2% with a family history, with no significant difference between the CD and UC groups (CD: 2.5% vs. UC: 5.5%, p = 0 317)
There was no significant difference between patients with CD and those with UC (CD: 1.2% vs. UC: 2.7%, p = 0 484)

Summary

Introduction

Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic relapsing and remitting disease. There have been numerous epidemiologic studies on IBD, the etiology of this disease remains unclear. IBD was believed to be a Western disease, as it is most prevalent in North America, Europe, and Oceania. The prevalence of IBD in the Western world is about 50–200 per 100,000 persons for CD and 120–200 per 100,000 persons for UC [1]. The incidence and prevalence rates of IBD have shown an increasing trend in Asia and Africa [2]. IBD has become a global disease in the 21st century with a large socioeconomic burden [2, 3]

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