title: Clinical epidemiology of ulcerative colitis in Arabs based on the Montréal classification.
abstract: OBJECTIVE
  To determine the clinical, epidemiological and phenotypic characteristics of ulcerative colitis (UC) in Saudi Arabia by studying the largest cohort of Arab UC patients.
  
  
  METHODS
  Data from UC patients attending gastroenterology clinics in four tertiary care centers in three cities between September 2009 and September 2013 were entered into a validated web-based registry, inflammatory bowel disease information system (IBDIS). The IBDIS database covers numerous aspects of inflammatory bowel disease. Patient characteristics, disease phenotype and behavior, age at diagnosis, course of the disease, and extraintestinal manifestations were recorded.
  
  
  RESULTS
  Among 394 UC patients, males comprised 51.0% and females 49.0%. According to the Montréal classification of age, the major chunk of our patients belonged to the A2 category for age of diagnosis at 17-40 years (68.4%), while 24.2% belonged to the A3 category for age of diagnosis at > 40 years. According to the same classification, a majority of patients had extensive UC (42.7%), 35.3% had left-sided colitis and 29.2% had only proctitis. Moreover, 51.3% were in remission, 16.6% had mild UC, 23.4% had moderate UC and 8.6% had severe UC. Frequent relapse occurred in 17.4% patients, infrequent relapse in 77% and 4.8% had chronic disease. A majority (85.2%) of patients was steroid responsive. With regard to extraintestinal manifestations, arthritis was present in 16.4%, osteopenia in 31.4%, osteoporosis in 17.1% and cutaneous involvement in 7.0%.
  
  
  CONCLUSIONS
  The majority of UC cases were young people (17-40 years), with a male preponderance. While the disease course was found to be similar to that reported in Western countries, more similarities were found with Asian countries with regards to the extent of the disease and response to steroid therapy.
authors.affiliation: Othman R Alharbi, Nahla A Azzam, Majid A Almadi, Khalid A Alswat, Nazia Sadaf, Abdulrahman M Aljebreen, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Othman R
authors.initials: OR
authors.lastname: Alharbi
authors.affiliation: Othman R Alharbi, Nahla A Azzam, Majid A Almadi, Khalid A Alswat, Nazia Sadaf, Abdulrahman M Aljebreen, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Nahla A
authors.initials: NA
authors.lastname: Azzam
authors.affiliation: Othman R Alharbi, Nahla A Azzam, Majid A Almadi, Khalid A Alswat, Nazia Sadaf, Abdulrahman M Aljebreen, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Almalki
authors.affiliation: Othman R Alharbi, Nahla A Azzam, Majid A Almadi, Khalid A Alswat, Nazia Sadaf, Abdulrahman M Aljebreen, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Majid A
authors.initials: MA
authors.lastname: Almadi
authors.affiliation: Othman R Alharbi, Nahla A Azzam, Majid A Almadi, Khalid A Alswat, Nazia Sadaf, Abdulrahman M Aljebreen, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Alswat
authors.affiliation: Othman R Alharbi, Nahla A Azzam, Majid A Almadi, Khalid A Alswat, Nazia Sadaf, Abdulrahman M Aljebreen, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Nazia
authors.initials: N
authors.lastname: Sadaf
authors.affiliation: Othman R Alharbi, Nahla A Azzam, Majid A Almadi, Khalid A Alswat, Nazia Sadaf, Abdulrahman M Aljebreen, Gastroenterology Division, King Khalid University Hospital, King Saud University, Riyadh 11461, Saudi Arabia.
authors.forename: Abdulrahman M
authors.initials: AM
authors.lastname: Aljebreen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018912:Arabs; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010641:Phenotype; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012074:Remission Induction; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013256:Steroids
keywords: Epidemiology; Inflammatory bowel disease information system; Saudi Arabia; Ulcerative colitis