The Demographic and Clinical Characteristics of Ulcerative Colitis in a Northeast Brazilian Population

Abstract

Introduction. The purpose of this study was to describe the clinical and demographic characteristics of UC in Bahia, a Brazilian state, and to identify the variables associated with extensive colitis, steroid therapy, immunosuppression, and colectomy. Methods. In this cross-sectional study UC patients were interviewed, and additional information was collected from the medical records. Descriptive statistics and multivariate Poisson regression analysis were used. Results. This study included 267 individuals, the mean age of whom was 39.4 years at diagnosis. There was a predominance of females and left-side colitis. Extensive colitis was positively associated with male gender, diarrhea, weight loss, and a younger age at diagnosis. In contrast, active smoking and a family history of IBD were negatively associated with extensive colitis. Positive associations were observed between steroid therapy and diarrhea, weight loss, urban patients, extraintestinal manifestations (EIMs), and hospitalization. Younger age and weight loss at diagnosis, a family history of IBD, extensive colitis, EIMs, hospitalization, and steroid therapy were all positively associated with immunosuppression. In contrast, Caucasian individuals, smokers, patients with rectal bleeding, and rural patients areas were all observed to have a decreased likelihood of immunosuppression. Conclusions. Our results corroborate the association between higher prevalence of extensive colitis and younger age at diagnosis. An association between steroid therapy and clinical presentation at diagnosis was observed. The observation that white individuals and rural patients use less immunosuppressive drugs highlights the need to study the influence of environmental and genetic factors on the behavior of UC in this population.

Inflammatory bowel disease epidemiology in São Paulo State, Brazil

“…In the group of patients with UC, there was a tendency toward an increase in incidence among patients over 60 years old. Such results are indistinct from the ones obtained in other Brazilian studies, such as those by Silva and Souza et al, and international studies, such as those by Burisch and Munkholm and Chouraki et al 8 , 14 , 19 , 23 We admit, however, that delay in the diagnosis of IBD can influence the outcome of the incidence distribution by age groups. In a recent study undertaken in the Northeast region of Brazil, a delay of up to 28.2 months was observed between the beginning of the clinical manifestations and the diagnostic confirmation of IBD.…”

Review of the epidemiology and burden of ulcerative colitis in Latin America

“…High hospitalisation rates were reported in Bahia, Brazil and Santiago, Chile, with 43.8% and 34.6% of patients requiring hospitalisation, respectively. 16 , 24 Colectomy rates varied between countries, with 22% of patients in Puerto Rico, 10.5% in Montevideo, Uruguay, 10.1% in Mexico City and 1.5–3.4% in Bahia, Brazil requiring a colectomy. 16 , 17 , 29 , 34 , 36 In Montevideo, Uruguay, 5.0% of patients underwent proctocolectomy (3.8% pouch and 1.3% definitive ileostomy) and 4.2% of patients required a colectomy.…”

Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

“…[50]One study found a higher prevalence of left-sided colitis, higher mortality, and higher usage of biological agents in Mexican population than in Mexican-American population, supporting the role of environmental factors on clinical characteristics of IBD. [24] The larger case-series in LAC Countries are from 1946 to date are from Argentina [14,51,52], Barbados [13], Brazil [14,[53][54][55][56][57][58][59][60][61][62][63][64][65], Chile [66][67][68], Cuba [69], Peru [70,71], Puerto Rico [72][73][74][75] and Uruguay. [76][77][78] Most CD localizations were ileal-colonic and CD behavior was mostly inflammatory, followed by penetrant or stenotic.…”