title: Demography and clinical course of ulcerative colitis in Arabs - a study based on the Montreal classification.
abstract: OBJECTIVE
  Ulcerative colitis (UC) is generally considered a disease of the Caucasian populations in developed countries, but its incidence is increasing rapidly in many developing countries, including the Middle East. The objective of this study was to determine the clinical epidemiology of UC in Arabs.
  
  
  METHODS
  This cross-sectional medical record-based descriptive study collected sociodemographic and clinical information on 182 Arab patients with UC in Kuwait. Age at diagnosis, extent and severity of disease were determined according to the Montreal classification. results: Among the 182 patients, 91 (50.0%) were males. The median age at diagnosis was 28.5 years. Family history of UC was reported by 26 (14.3%) patients. The extent of the disease was limited to the rectum in 34 (18.7%) patients, left sided in 67 (36.8%) and pan colitis in 81 (44.5%). At the time of inclusion in the study, 127 (69.8%) patients were in clinical remission, 53 (29.1%) had mild-to-moderate disease and 2 (1.1%) had severe colitis. Younger age at diagnosis and non-smoking were associated with more extensive colitis. The majority of patients were treated with mesalamine, steroids and immunomodulators, while biologic therapy and surgery were needed in 5% and 4% of the patients, respectively.
  
  
  CONCLUSIONS
  UC presents more commonly at younger age among Arabs in Kuwait. Extensive disease at presentation is associated with younger age at diagnosis and absence of tobacco smoking. There also appears to be less need for surgery and biologic therapy for the disease in this population.
authors.affiliation: Department of Medicine, Faculty of Medicine, Kuwait University , Safat , Kuwait.
authors.forename: Iqbal
authors.initials: I
authors.lastname: Siddique
authors.forename: Waleed
authors.initials: W
authors.lastname: Alazmi
authors.forename: Jaber
authors.initials: J
authors.lastname: Al-Ali
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Longenecker
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al-Fadli
authors.forename: Fuad
authors.initials: F
authors.lastname: Hasan
authors.forename: Anjum
authors.initials: A
authors.lastname: Memon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018912:Arabs; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007730:Kuwait / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Arab; Kuwait; Montreal classification; inflammatory bowel disease; ulcerative colitis