title: Gastrointestinal complications and extraintestinal manifestations of inflammatory bowel disease in Taiwan: A population-based study.
abstract: BACKGROUND
  Despite a rising incidence of inflammatory bowel disease (IBD) in Taiwan, the clinical presentation of IBDs in this population has yet to be well characterized. Therefore, the aim of our study was to identify and describe the clinical features of gastrointestinal (GI) complications and extraintestinal manifestations (EIMs) of IBDs in the Taiwanese population.
  
  
  METHODS
  We conducted a retrospective study between 1998 and 2011, with relevant medical information extracted from the National Health Insurance Research Database. The diagnoses of IBD, GI complications, and EIMs were defined from the health registry using the appropriate International Classification of Diseases 9 codes.
  
  
  RESULTS
  A total of 3153 patients with IBDs were identified: 611 with Crohn's disease (CD) and 2542 with ulcerative colitis, with GI complications and EIMs identified in 22.2% and 11.9% of cases, respectively. CD was associated with an increased incidence of intestinal fistula, perforation, obstruction, peritonitis and perianal disease, and ulcerative colitis with benign neoplasm of the colon. Colorectal cancer developed in 0.35% of patients. Children with CD characteristically have more complex intestinal complications. The prevalence of EIMs was higher in females and in CD, with peripheral arthritis identified as the most common EIMs, overall. The rate of major EIMs affecting the articular, cutaneous, and visual systems was lower than the rate reported in Western countries.
  
  
  CONCLUSIONS
  Our study found that CD had a more complicated course, with a higher incidence of GI complications and EIMs. However, the prevalence of intestinal complications, perianal disease, and major EIMs was less common than in Western countries. This study provided a distinct clinical feature of IBD in Taiwan.
authors.affiliation: Division of Gastroenterology, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Yung-Cheng
authors.initials: YC
authors.lastname: Hsu
authors.affiliation: Division of Gastroenterology, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. Electronic address: tcwu@vghtpe.gov.tw.
authors.forename: Tzee-Chung
authors.initials: TC
authors.lastname: Wu
authors.affiliation: Division of Gastroenterology, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Lo
authors.affiliation: Division of Gastroenterology, Children's Medical Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Li-Shu
authors.initials: LS
authors.lastname: Wang
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013624:Taiwan
keywords: Crohn’s disease; extraintestinal manifestations; inflammatory bowel disease; ulcerative colitis