Ulcerative Colitis in Kuwait: A Review of 90 Cases

Abstract

Background: Chronic ulcerative colitis is a disease of unknown etiology. Its incidence is on the rise in various developing countries as has been reported in studies from South-East Asia and the Middle East. There seems to be significant differences in the pattern and the clinical course of this disease in our patient population. The aim of our study is to assess the incidence and the clinical course of the disease in Kuwait. Methods: This is a retrospective study of cases identified over a period of 14 years (1985–1999). Three hundred forty-six patients were identified to have chronic ulcerative colitis. Ninety patients were interviewed for this study. Results: Chronic ulcerative colitis is being identified with increasing frequency. Our local incidence was 2.8 per 100,000 persons per year. The disease was seen in both sexes with equal frequency. It peaks at the third decade of life, with no second peak observed in the sixth decade. The disease was of mild to moderate severity in 93% of the cases. The distribution of the disease in the colon showed pancolitis in 45%, left-sided colitis in 14%, proctosigmoiditis in 21% and proctitis in 20%. Arthritis and arthralgia were the most frequent extraintestinal manifestation seen in 31%. Perianal disease, although rare in ulcerative colitis, was seen in 8%. Of interest is the fact that over 14 years of follow-up, none of our patients developed high-grade dysplasia or colorectal cancer. Four patients required total colectomy mainly due to failure of medical therapy. Conclusions: Chronic ulcerative colitis is occurring with increasing frequency similar to that seen in Western countries. The disease observed in our patient population was of mild to moderate severity, with fewer complications than reported in Western countries. It peaks in the third decade with no second peak. None of our patients developed high-grade dysplasia or colorectal carcinoma.

Epidemiologic study of 80 patients with ulcerative colitis referred to Imam Hospital in Ardabil city during 2004-2011

“…The prevalence and incidence rates in present study was not according to other studies in Sweden (incidence 2.1%), America (prevalence 35-100%), Colombia (prevalence 29%), Amman (prevalence 10.4%), Barbados (incidence 1.85), California (incidence 3.2) per 100000 people. 11,22,[24][25][26][27] Study carried out in Colombia showed prevalence 30.4 for women and 12 for men which was in contrast of our study. 25 can state that, IBD is a most common in West of the world and its incidence has increased since 1950.…”

Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East

“…Among the Asian countries, it was highest in mainland China (Guangzhou: 3.4/ 100,000) followed by Hong Kong (3.06/100,000), and Macau (2.2/100,000). Data from Western Asia including studies from Kuwait [6] , Turkey [7] , and Israel [8] revealed an incidence rate of 2.8/100,000 and 5.04/100,000 in Kuwait and Israel, respectively, and a prevalence of 4.9/100,000 and 167/100,000 in Turkey and Israel, respectively.…”

Clinical features and epidemiology of spondyloarthritides associated with inflammatory bowel disease

“…Souza et al [49] , in a mixed Brazilian IBD population found a prevalence of 14.4%, with no difference between CD and UC. Al-Shamali et al [50] reported [43] 2008…”