Abstract
Background and objective: The incidence of inflammatory bowel disease (IBD) over the past years in Romania has been on the rise, but epidemiologic data are lacking. The aim of this study was to define the characteristics of IBD, the trends and phenotype among IBD patients in Romania. Material and methods: We conducted a prospective study over a period of 12 years, from 2006 to 2017. All patients diagnosed with IBD on clinical, radiological, endoscopic and histological features were included. We divided the country into eight regions: west (W), north-east (NE), north-west (NW), south-east (SE), south-west (SW), south (S), central (C) and Bucharest-Ilfov (B), and data were analyzed accordingly. Results: A total of 2724 patients were included in this database, but only 2248 were included in the final analysis, with all data available. Of the 2248 patients, 935 were Crohn’s disease (CD), 1263 were ulcerative colitis (UC) and 50 were IBD-undetermined. In UC phenotypes we observed more frequent left-sided colitis (50.5%, p < 0.0001), and in CD phenotype we observed more frequent colonic and ileo-colonic localization (37.8% and 37.6%, p < 0.0001). The region with the most IBD cases was NE (25.1%) and with the least IBD cases was SW (4.9%). UC was found more frequently in NE (32%), while CD was found more frequently in Bucharest (28.6%). Conclusions: In Romania, ulcerative colitis is more frequent than CD. UC is predominant in the northern part of Romania, while CD has become predominant in the southern part of the country. IBD occurs more in the male population, and in urban and industrialized areas. There are differences between the regions in Romania regarding IBD phenotypes, gender distributions, age distribution, treatment, smoking status and complications.
Highlights
Inflammatory bowel disease (IBD) is a chronic, relapsing, inflammatory disorder of the gastrointestinal tract and includes ulcerative colitis (UC) and Crohn’s disease (CD), which shows differences in the pathology and clinical characteristics
When we compared the inflammatory bowel disease (IBD) patients between the eight regions of Romania we found out that there were significant differences between them (p < 0.05), regarding gender distribution, number of there were significant differences between them (p < 0.05), regarding gender distribution, number of cases, IBD distribution and complications
40 years, male gender, family with the ulcerative colitis predominance, we found out that age above years, male gender, history and rural provenance were associated with the presence of ulcerative colitis in that area.positive
Summary
Inflammatory bowel disease (IBD) is a chronic, relapsing, inflammatory disorder of the gastrointestinal tract and includes ulcerative colitis (UC) and Crohn’s disease (CD), which shows differences in the pathology and clinical characteristics. The etiology and pathogenesis of IBD are still poorly understood. It is widely accepted that the pathogenesis of IBD comprises genetic factors and environmental factors [1]. More than 100 genes have been identified by the genome-wide association scan to increase the susceptibility to IBD [2]. Genetic susceptibility cannot completely explain the high incidence and prevalence of IBD observed in developed and developing countries [3]. Information regarding the epidemiology of IBD world-wide is poor, especially information about. The incidence of inflammatory bowel disease (IBD) over the past years in Romania has been on the rise, but epidemiologic data are lacking. The aim of this study was to define the characteristics of IBD, the trends and phenotype among IBD patients in Romania
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