Inflammatory Bowel Disease in Sari, Northern Iran: Review of 302 Patients

Considering the unknown etiology of inflammatory bowel disease (IBD), the epidemiologic evaluation may help to identify the causative agents of the disease. Genetic (ethnic) and environmental (e.g., geographic) factors in Iran may influence the incidence of the disease. The objective of this study was to determine the demographic and clinical characteristics of the IBD in the city of Sari, northern Iran. All patients with IBD who referred to a private clinic of gastroenterology or Department of Gastroenterology of Imam Khomeini Hospital, Sari, Iran during 2000 to 2007 were included in this study. Age of onset, gender, level of education, resident place, extension of disease, extra-intestinal manifestations, the necessary surgical interventions, and associated diseases were assessed. Out of 302 IBD patients enrolled in this study, 265 (87.7%) had ulcerative colitis (UC), and 35 (11.5%) had Crohn's disease (CD). CD patients were younger than UC patients at the diagnosis. There was no significant difference between the gender and IBD involvement. Most of the patients aged between 20 and 40 years. Left-sided UC was the most common type (48.3%). Family history was positive in 3.4% of UC patients; it was negative among CD patients. Twenty-six (8.7%) patients with IBD had at least one extra-intestinal manifestation. The demographic and clinical characteristics of IBD are almost similar to other reports from developing countries. Although the true epidemiologic picture of IBD in Sari is still unknown, IBD is not as rare as was previously thought. Gradual acceptance of a Western lifestyle may be responsible for the observed continuing rise in the incidence of IBD.