Open AccessUlcerative colitis in a Southern European country: A national perspective
Author(s) -
Portela Francisco,
Magro Fernando,
Lago Paula,
Cotter José,
Cremers Isabelle,
de Deus João,
Vieira Ana,
Lopes Horácio,
Caldeira Paulo,
Barros Luísa,
Reis Jorge,
Carvalho Laura,
Gonçalves Raquel,
Campos Mário J.,
Ministro Paula,
Duarte Maria A.,
Amil Jorge,
Rodrigues Susana,
Azevedo Luís,
CostaPereira A.
Publication year - 2010
Publication title -
inflammatory bowel diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.932
H-Index - 146
eISSN - 1536-4844
pISSN - 1078-0998
DOI - 10.1002/ibd.21119
Subject(s) - ulcerative colitis , portuguese , incidence (geometry) , medicine , perspective (graphical) , colitis , demography , disease , computer science , physics , optics , linguistics , philosophy , artificial intelligence , sociology
Background: The incidence, prevalence, and even the clinical behavior of ulcerative colitis (UC) are highly variable in different world regions. In previous studies, Portugal was reported as having a milder clinical behavior. The aim of this study was to apply the Montreal Classification in a large group of UC Portuguese patients in order to describe their clinical characteristics and evaluate variables potentially useful for outcome prediction. Methods: A cross‐sectional study based on data collected from a nationwide online registry was undertaken. Results: In all, 2863 patients with UC were included. Twenty‐one percent had ulcerative proctitis, 52% left‐sided colitis, and 28% extensive colitis. Sixty percent of patients had taken steroids, 14% immunosuppressors, 1% biologicals, and 4.5% were submitted to surgery. Patients with extensive colitis had more severe activity, needing more steroids, immunosuppressors, and surgery. At the time of diagnosis 61% were less than 40 years old and 5% less than 16. Younger patients also had a more aggressive initial course. Thirty‐eight percent of patients had only taken salicylates during the disease course and were characterized by a lower incidence of systemic symptoms at presentation (3.8% versus 8.8%, P < 0.001), fewer extraintestinal manifestations (7.7% versus 24.0%, P < 0.001), and a higher prevalence of proctitis (32.1% versus 10.0%). Conclusions: A more aggressive phenotype was found in extensive colitis and in the initial course of younger patients, with an increased need for steroids and immunosuppressors. In addition, a significant percentage of patients, particularly with proctitis, showed a milder clinical evolution and were maintained in remission only with salicylates. (Inflamm Bowel Dis 2009)