Background: The prevalence of inflammatory bowel disease (IBD) has increased worldwide. However, there are few studies that described the epidemiology and clinical behavior of IBD in South America. The aim of this study was to describe phenotype and clinical evolution of IDB in a central city from Argentina.
Methods: We performed a descriptive observational study in order to describe all patients with IBD diagnosis that assisted to ten centers (public and private) from Cόrdoba city (Argentina) between 06/2014–09/2016. Cόrdoba is the second largest city in population from Argentina with 1,300,000 inhabitants and represents almost 3.3% of the country population. During the registry data were recorded on standardized forms and information on demography, clinical evolution, endoscopic finding, and therapy were evaluated.
Results: A total of 454 patients were included. The ratio of ulcerative colitis (UC) (n=394, 86.8%) and Crohn's disease (CD) (n=56, 12.3%) was 7.04: 1. Mean age at diagnosis was 39.5 years (SD 16.4), with similar distribution by gender. At the moment of diagnosis, diarrhea and bleeding were more frequent manifestations in patients with UC; and abdominal pain and weight loss were the main presentation in patients with CD. Extra intestinal manifestations (with a predominance of joint involvement) were present in 20.2% of patients and were similar in UC and CD. The distribution of UC was: 34.18% proctitis, 48.72% left colitis and 17.1% pancolitis. The most common site of involvement in CD patients was: 45% colonic, 25.7% ileocolonic, 17% ileum, and 2.3% had upper gastrointestinal tract involvement. The phenotype of CD was 42.1% inflammatory, 31.6% fibrostenotic, 10.5% perianal, and 15.8% fistulizing/perforating. Anti-TNF therapy was used in 2.3% of patients with UC compared to 26.7% of patients with CD (p<0.001). The rate of surgery was 3.8% for patients with UC compared to 41% in patients with CD (p<0.001). CD patients with inflammatory and fibrostenotic behavior presented a lower percentage of surgery.
Conclusions: We observed a predominance of UC in our population with lower rate of anti-TNF therapy and surgery. Compared to other series in South America, patients with CD diagnosis presented a higher frequency colonic involvement and lower need of anti-TNF therapy.