INFLAMMATORY BOWEL DISEASE IN HONG KONG CHINESE: A RETROSPECTIVE STUDY IN A REGIONAL HOSPITAL

Abstract

Background: Inflammatory bowel disease (IBD) is reported to be rare in the Hong Kong Chinese.Aim: To study the characteristics of IBD in our ethnic Chinese.Method: We performed a retrospective analysis of all consecutive Chinese patients of IBD diagnosed and treated at our hospital from year 1993 to 2000.Results: There were 35 and 15 patients with an established diagnosis of ulcerative colitis (UC) and Crohn’s disease (CD), respectively, as determined by a combination of clinical, radiological, endoscopic and histologic criteria. The male to female ratio was 1 : 1.3 and 1 : 1.1 for UC and CD, respectively. The mean age at diagnosis was 42.0 (range, 18–79) and 41.1 (range, 10–74) for UC and CD, respectively. No documented positive correlation between smoking and CD was evident. None of the patients had a family history of IBD. Common presenting symptoms were blood in stool (86%), diarrhoea (71%), abdominal pain (49%) and weight loss (14%) for UC. Main presenting symptoms for CD were abdominal pain (55%), diarrhoea (45%), blood in stool (45%) and weight loss (36%). Extraintestinal manifestations were rare. One patient had sclerosing cholangitis in association with UC. Another patient with CD developed sacroiliitis. Of the 15 patients with CD, 8 had ileocolic disease (55%), 5 colonic disease alone (36%) and 2 isolated small intestine disease alone (9%). A predilection to involve the colon (87%) is a distinct feature. Of the 35 patient with UC, 11 had proctitis (31%), 8 rectosigmoiditis (24%), 3 left sided colitis (9%) and 13 extensive colitis (39%). All patients with UC responded to medical therapy. None required surgical resection. Ten patients (67%) with CD responded to medical therapy alone. Surgical resection was undertaken in 5 CD patients (33%).Conclusions: In comparison with Western figures, a relatively higher proportion of distal colitis alone namely, proctitis and rectosigmoiditis was seen in our Chinese UC patients whereas a predilection to involve the colon was a distinct feature in our Chinese CD patients. A higher age at diagnosis and the absence of family history were also characteristic features of IBD patients in our series.