Fenotype van inflammatoire darmziekten bij diagnose*

Objective

To describe the clinical characteristics of patients with inflammatory bowel disease (IBD) at diagnosis at the population level in the Netherlands.

Design

Observational cohort study.

Method

All new IBD patients who were diagnosed in the period 1 January-31 December 2006 in 9 general hospitals in the southwest of the Netherlands were included in this study.

Results

A total of 413 patients were enrolled, of which 201 with Crohn’s disease (CD) (48.7%), 188 with ulcerative colitis (UC) (45.5%), and 24 IBD unclassified (IBDU) (5.8%), with a median age of 38 years (range: 14-95). At diagnosis 78 patients with CD (38.8%) had ileocolonic disease and 73 patients (36.3%) had colitis. In 8 patients (4.0%), the upper gastrointestinal tract was involved. Nineteen patients with CD (9.5%) had perianal disease. Thirty-nine patients with CD (19.4%) had stricturing phenotype. Of the patients with UC and IBDU, 39 (18.4%) suffered from pancolitis and 61 (29%) from proctitis. Severe endoscopic lesions at diagnosis were seen in 119 patients (28.8%, 68 CD, 49 UC, and 2 IBDU), whereas 98 patients (23.7%) had severe histological disease activity. Twenty-two patients (5.3%, 20 CD and 2 UC) had fistula at diagnosis.

Conclusion

In this cohort, a third of the patients with CD had complicated IBD disease at diagnosis. Severe endoscopic lesions were reported in 34% of the patients with CD and 26% of the patients with UC. In order to avoid further complications and the debilitating aspect of the disease, it is important to control the disease as soon as possible after diagnosis. To achieve this goal, it might be advisable to start more potent drugs sooner.

Conflict of interest: disclosure forms provided by the authors are available along with the full text of this article at www.ntvg.nl, search for A7119; click on ‘Belangenverstrengeling’ (‘Conflict of interest’). Financial support for this article: V.J.A.A. Nuij and C.J. van der Woude have received a research grant from Dr. Falk Benelux B.V.