A Study on Epidemiological Features and Clinical Manifestations among Crohn and Ulcerative Colitis Patients Admitted to Treatment Centers of Ahvaz, Iran

Document Type : Original Article


1 Assistant Professor of Immunology.Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical

2 MSC Student of Immunology.Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Associate Professor of Internal Medicine.Department of Internal Medicine Specialty GI Tract, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

4 Associate Professor of Internal Medicine.Department of Internal Medicine Specialty GI, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.


Background and Objective: Inflammatory bowel disease (IBD), including Crohn's and ulcerative colitis is a complex multifactorial disease with unknown exact cause. This study investigated the epidemiological features and clinical manifestations of IBD referred to GIT specialists in the city of Ahvaz, Iran.
Subjects and Methods:In this cross-sectional study, from Sep 2013 to May 2015, 115 patients with confirmed diagnosis of IBD included 35 patients with Crohn’s disease and 80 patients with ulcerative colitis were evaluated. Data collection was based on a prepared patient questionnaire and Chi square  test analyzed by spss software ver 22.
Result: The mean and ± SD age of patients at diagnosis was 26.09  ±10.69 and 30.09 ± 9.84 yr in patients with ulcerative colitis and Crohn' disease respectively. Women were the dominant sex in both diseases.  In Crohn's disease, enteric phenotype had the highest percentage (42.9 %) and in terms of the behavior of the disease, inflammatory was 80% more common. In patients with ulcerative colitis in terms of feature, pancolitis with 46.25 %  was more than others. In comparison between Crohn' disease and ulcerative colitis significant differences observed for pain in the back P=0.004, blood in the stool P=0.017, headache P=0.004 and age  P< 0.001 The frequency of all these four  features  among patients with ulcerative colitis were significantly higher than among Crohn's disease patients.
Conclusions: The finding of this study demonstrated that among IBD patients in our area, enteric phenotype and inflammatory behavior in Crohn's disease and pancolitis phenotyp in ulcerative colitis e are more prevalent.


1-Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G, "et al". Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012 Jan; 142(1): 46-54. PubMed PMID: 220.1864.
2-Lakatos L, Lakatos PL. Is the incidence and prevalence of inflammatory bowel diseases increasing in Eastern Europe? Postgraduate Med J 2006 May; 82(967): 332-7. PubMed PMID: 16679472.
3-Safarpour AR, Hosseini SV, Mehrabani D. Epidemiology of inflammatory bowel diseases in iran and Asia; a mini review. Iranian journal of medical sciences. 2013 Jun; 38(2 Suppl):140-9. PubMed PMID: 24031103.
4-Valdez R, Appelman HD, Bronner MP, Greenson JK. Diffuse duodenitis associated with ulcerative colitis. The Ame J Surg pathol 2000 Oct; 24(10):1407-13. PubMed PMID: 11023103.
5-Yantiss RK, Odze RD. Diagnostic difficulties in inflammatory bowel disease pathology. Histopathology 2006 Jan; 48(2):116-32. PubMed PMID: 16405661.
6-Kornbluth A, Sachar DB, Practice Parameters Committee of the American College of G. Ulcerative colitis practice guidelines in adults (update): American College of Gastroenterology, Practice Parameters Committee.  Am J gastroenterol 2004 Jul; 99(7): 1371-85. PubMed PMID: 15233681.
7-Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006Jun; 55(6): 749-53. PubMed PMID: 16698746.
8-Brand S, Staudinger T, Schnitzler F, Pfennig S, Hofbauer K, Dambacher J, "et al". The role of Toll-like receptor 4 Asp299Gly and Thr399Ile polymorphisms and CARD15/NOD2 mutations in the susceptibility and phenotype of Crohn's disease. Inflamm Bwel Dis 2005 Jul;11(7):645-52. PubMed PMID: 15973118.
9-Cummings JR, Ahmad T, Geremia A, Beckly J, Cooney R, Hancock L, "et al". Contribution of the novel inflammatory bowel disease gene IL23R to disease susceptibility and phenotype. Inflamm Bowel Dis2007 Sep; 13(9): 1063-8. PubMed PMID: 17508420.
10-Beattie RM, Croft NM, Fell JM, Afzal NA, Heuschkel RB. Inflammatory bowel disease. Arch Dis Child 2006 May; 91(5): 426-32. PubMed PMID: 16632672.
11-Naser SA, Arce M, Khaja A, Fernandez M, Naser N, Elwasila S, "et al". Role of ATG16L, NOD2 and IL23R in Crohn's disease pathogenesis. World J Gastroenterol 2012 Feb 7; 18(5): 412-24. PubMed PMID: 22346247.
12-Silverberg MS, Cho JH, Rioux JD, McGovern DP, Wu J, Annese V, "et al". Ulcerative colitis-risk loci on chromosomes 1p36 and 12q15 found by genome-wide associationstudy. Nature genetics 2009 Feb; 41(2): 216-20. PubMed PMID: 19122664.
13-Zhang SZ, Zhao XH, Zhang DC. Cellular and molecular immunopathogenesis of ulcerative colitis. Cellular & molecular immunology 2006 Feb; 3(1): 35-40. PubMed PMID: 16549047.
14-Aghazadeh R, Zali MR, Bahari A, Amin K, Ghahghaie F, Firouzi F. Inflammatory bowel disease in Iran: a review of 457 cases. J Gastroenterol Hepatol 2005 Nov; 20(11):1691-5. PubMed PMID: 16246187.
15-Shirazi KM, Somi MH, Bafandeh Y, Saremi F, Mylanchy N, Rezaeifar P, "et al". Epidemiological and clinical characteristics of inflammatory bowel disease in patients from northwestern iran. Middle East J Dig Dis2013 Apr; 5(2): 86-92. PubMed PMID: 2482.
16-Fani A. A study on the pattern prevalence of inflammatory bowel  disease and it's clinical  presentation in  arak. Arak Med Uni J 2002;18(5): 23-8.
17-Darakhshan F,  Vali Khojeini E, Balaii H , Naderi N , Firouzi F, Farnood A, "et al".  Epidemiology of Inflammatory Bowel Disease in Iran: A review of 803 cases.  Gastroenterol Hepatol 2008; 1: 19-24.
18-Masjedi zadeh R, Hashemi SJ , Azmi M , Shayesteh Ak.  Epidemiological Features of Inflammatory Bowel Disease in Khozestan. Jentashapir 2007; 1.
19-Fauci A KD, Hauser S, Jameson J, Loscalzo J. Inflammatory bowel disease. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson  JL, Loscalzo J. Harrison's Internal Medicine. 18thed. New York: McGraw Hill; 2012.
20-Zahedi MJ, D-m S, Haiatbakhsh M, Dalirsani Z. Demographic and Clinical Features of Ulcerative Colitis Patients in Kerman City during 2005-2007. Kerman Uni Med Sci J 2009; 16(1): 45-53.
21-Taherkhani R, Farshadpour F , Esmaeilizadeh M , Dolatshahi M , Makvandi A , Hamzavi G. Epidemiologic Characteristics and Frequency of Anatomical Pattern of Ulcerative Colitis in Patients Referred to Imam Khomeini Hospital During Years 2007 to 2011. Jundishapur Sci Med J 2014Jul-Aug; 13(3): 275-82.
22-Ghadir M R,  MMFN, Sarkishikyan S, Yazdani S, Behbahani I. Inflammatory BowelDiseases in Center of Iran,QOM Province, 2007-2011. Qom Uni Med Sci J 2014; 8(3): 41-8.
23-Fakheri H. Inflammatory Bowel Disease in Sari, Northern Iran: Review of 302 Patients. Govaresh 2007; 12 (3):155-60.
24-Naderi N, Farnood A, Habibi M, Derakhshan F, Balaii H, Motahari Z, "et al". Association of vitamin D receptor gene polymorphisms in Iranian patients with inflammatory bowel disease. J Gastroenterol Hepatol 2008 Dec; 23(12):1816-22. PubMed PMID: 18752562.
25-Naderi N, Ebrahimi Daryani N, Farnood A, Habibi M, Balaii H, Sharifiani A,"et al". The role of NOD2 common mutations in Crohn's disease. J Res Med Sci 2012; 36(1): 29-34.
26-Al-Shamali MA, Kalaoui M, Patty I, Hasan F, Khajah A, Al-Nakib B. Ulcerative colitis in Kuwait: a review of 90 cases. Digestion 2003; 67(4): 218-24. PubMed PMID: 12966229.