Factors associated with disease evolution in Greek patients with inflammatory bowel disease

• Published in: BMC gastroenterology Vol. 6; no. 1; p. 21
• Main Authors: Chatzicostas, Constantinos, Roussomoustakaki, Maria, Potamianos, Spiros, Paspatis, Gregorios, Mouzas, Ioannis, Romanos, John, Mavrogeni, Helen, Kouroumalis, Elias
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25-07-2006; BioMed Central; BMC
• Subjects: Adult; Behavior Therapy; Colitis, Ulcerative - classification; Colitis, Ulcerative - etiology; Colitis, Ulcerative - pathology; Colitis, Ulcerative - physiopathology; Crohn Disease - classification; Crohn Disease - etiology; Crohn Disease - pathology; Crohn Disease - physiopathology; Disease Progression; Female; Follow-Up Studies; Greece; Humans; Male; Middle Aged; Odds Ratio; Phenotype; Proctitis - complications; Risk Factors; Smoking - adverse effects; Smoking - psychology; Greece
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/1471-230X-6-21

The majority of Crohn's disease patients with B1 phenotype at diagnosis (i.e. non-stricturing non-penetrating disease) will develop over time a stricturing or a penetrating pattern. Conflicting data exist on the rate of proximal disease extension in ulcerative colitis patients with proctitis or left-sided colitis at diagnosis. We aimed to study disease evolution in Crohn's disease B1 patients and ulcerative colitis patients with proctitis and left-sided colitis at diagnosis.
116 Crohn's disease and 256 ulcerative colitis patients were followed-up for at least 5 years after diagnosis. Crohn's disease patients were classified according to the Vienna criteria. Data were analysed actuarially.
B1 phenotype accounted for 68.9% of Crohn's disease patients at diagnosis. The cumulative probability of change in disease behaviour in B1 patients was 43.6% at 10 years after diagnosis. Active smoking (Hazard Ratio: 3.01) and non-colonic disease (non-L2) (Hazard Ratio: 3.01) were associated with behavioural change in B1 patients. Proctitis and left-sided colitis accounted for 24.2%, and 48.4% of ulcerative colitis patients at diagnosis. The 10 year cumulative probability of proximal disease extension in patients with proctitis and left-sided colitis was 36.8%, and 17.1%, respectively (p: 0.003). Among proctitis patients, proximal extension was more common in non-smokers (Hazard Ratio: 4.39).
Classification of Crohn's disease patients in B1 phenotype should be considered as temporary. Smoking and non-colonic disease are risk factors for behavioural change in B1 Crohn's disease patients. Proximal extension is more common in ulcerative colitis patients with proctitis than in those with left-sided colitis. Among proctitis patients, proximal extension is more common in non-smokers.