Clinical uniformity of inflammatory bowel disease at presentation and during the first year of disease in the north and south of Europe

Abstract

To compare the methods used for diagnosis and the clinical features of non-specific inflammatory bowel disease (IBD) in the north and south of Europe. A prospective study over 2 years in 1991-3 at eight centres in the north and 12 in the south of Europe using the same criteria for disease definition and same protocol for recording data. Specialist gastroenterological centres with good diagnostic facilities at which every effort was made to ascertain all new cases of IBD seen in other departments and primary care in a defined geographical area of known population. A total of 2201 patients newly diagnosed as suffering from IBD, 1397 with ulcerative colitis (UC), 706 with Crohn's disease (CD) and 116 with indeterminate colitis (IND). Diagnostic methods used were similar in north and south, a biopsy or resection specimen was available for examination in 94 and 95%, of cases of UC and 92 and 87% of CD in north and south, respectively. The type, clinical presentation, site and extent of disease were similar in north and south. Treatment followed a common pattern and mortality from IBD was low in the first year after diagnosis. In both areas, age of onset of UC tended to be later than CD. The standard of diagnosis and clinical features of IBD are similar in specialist centres throughout Europe so providing a valid basis for this aspect of collaborative epidemiological or other studies.