Epidemiology and Clinical Outcomes of Inflammatory Bowel Disease: A Hospital-Based Study in Central Taiwan

Abstract

The incidence and prevalence of inflammatory bowel disease (IBD) are low but increasing in Taiwan. We aimed to investigate the epidemiology and clinical outcomes of IBD in central Taiwan. We retrospectively analyzed patients with IBD diagnosed at our hospital between January 2000 and September 2018. The diagnostic criteria were based on endoscopic and pathologic findings. Clinical characteristics, treatment regimens, and treatment outcomes were analyzed. A total of 190 patients with IBD were enrolled (80 with Crohn’s disease (CD) and 110 with ulcerative colitis (UC)). The mean age at diagnosis was 38.4 years (CD: 36 years, UC: 40 years). Male patients accounted for the majority of patients (71.1%). The male-to-female ratio was 3 : 1 for CD and 2.1 : 1 for UC. Current and ever smokers accounted for 30.5% of all patients. Only 4.2% of patients had a family history of IBD. Extraintestinal manifestations (EIMs) were reported in 7.9%, and colorectal cancers (CRCs) were reported in 2.1% of all patients. In patients with CD, the ileal type was the most common disease phenotype (57.5%), and the stricturing type was the most common disease behavior (60.0%). In patients with UC, left-sided colitis was the predominant disease extent (42.7%). The seroprevalence of hepatitis B virus (HBV) was 13.3%. The incidence of perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in patients with UC was 22%. 5-Aminosalicylic acids were the preferred treatment for UC, whereas corticosteroids, immunomodulators, and biologic agents were preferred for CD. In patients with CD, the bowel resection rate was 38.8%, and the incidence of hip avascular necrosis was 3.8%. In Taiwan, patients with IBD showed a male predominance, lack of familial clustering, a higher prevalence of HBV infection, and a lower prevalence of p-ANCA, EIMs, and CRC. Moreover, a higher incidence of the ileal type with poor outcomes of CD and left-sided predominance in UC were found.

Temporal trend of disease recognition, treatment paradigm, and clinical outcomes of Crohn disease in Thailand from 2000 through 2017

“…The majority of cohorts from Asia also showed L2 to be the least likely location of involvement; however, more colonic involvement was found in Western cohorts. [ 3 , 6 , 13 , 16 , 20 , 27 , 34 , 40 , 41 , 44 , 48 ] Similar to other studies, most of the patients in our study had inflammatory phenotype at diagnosis.…”

“…The reported mean or median age at diagnosis in those studies was mostly within the range of 20 to 40 years. [ 3 , 6 , 9 , 12 – 14 , 16 , 20 , 22 , 25 , 27 , 28 , 30 , 34 , 40 , 41 , 44 , 48 – 50 ] There was no gender preference in our cohort, which is similar to many cohorts from Western countries, [ 3 , 20 , 31 , 35 , 41 ] but most cohorts from Asia reported male predominance at 60% to 70%. [ 6 , 9 , 13 , 15 , 22 , 27 , 28 , 30 , 34 , 44 , 48 , 49 ] The locations of disease at diagnosis in our cohort were L3 (40%), L1 (35%), and L2 (25%).…”

The Effectiveness of Probiotics in the Treatment of Inflammatory Bowel Disease (IBD)—A Critical Review

“…Generally, it is estimated that three million people in Europe [ 4 ], three million Americans [ 5 ], and more than 80,000 Australians [ 6 ] are affected by IBD. Additionally, increasingly, new cases are observed in Asia and Africa [ 7 , 8 ]. The exact causes of IBD are still unknown.…”

Clinical features and treatment of inflammatory bowel disease in a low-incidence area

“…Inflammatory bowel disease (IBD) including Crohn disease (CD) and ulcerative colitis (UC) is common in the Western world but relatively uncommon in Asian countries such as Taiwan. [ 1 – 4 ] Both the incidence and prevalence of IBD increased in those low incidence and prevalence countries in the past 2 decades. [ 1 , 5 , 6 ] The reason for globalization of this Western disease has not been established but is most likely related to environment factors, including improved hygiene, civilization, and the introduction of Western lifestyle diet.…”

“…[ 1 , 9 ] Therefore, high-quality territory-wide registry data [ 10 ] or hospital-based real-world data are required for further understanding the disease features, treatment patterns, and quality of care of patients with IBD in Taiwan. [ 4 , 8 , 11 ] Therefore, we conducted the present study aimed to review the clinical features of patients with IBD from tertiary referral center in Taiwan.…”