Epidemiological and clinical characteristics of inflammatory bowel diseases in Cairo, Egypt

Abstract

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.

Keywords: Epidemiology of Crohn’s disease; Epidemiology of Ulcerative colitis; Epidemiology of inflammatory bowel diseases in Egypt; Incidence of Crohn’s disease; Incidence of ulcerative colitis; Natural history of Inflammatory bowel diseases; inflammatory bowel diseases Prevalence.

Figures

Figure 1

Number of ulcerative colitis and Crohn’s disease cases over the first, second and last five years of the 15 years duration.