Background:
The incidence, prevalence, and even the clinical behavior of ulcerative colitis (uc) are highly variable in different world regions. in previous studies, portugal was reported as having a milder clinical behavior. the aim of this study was to apply the montreal classification in a large group of uc portuguese patients in order to describe their clinical characteristics and evaluate variables potentially useful for outcome prediction.
Methods:
A cross-sectional study based on data collected from a nationwide online registry was undertaken.
Results:
In all, 2863 patients with uc were included. twenty-one percent had ulcerative proctitis, 52% left-sided colitis, and 28% extensive colitis. sixty percent of patients had taken steroids, 14% immunosuppressors, 1% biologicals, and 4.5% were submitted to surgery. patients with extensive colitis had more severe activity, needing more steroids, immunosuppressors, and surgery. at the time of diagnosis 61% were less than 40 years old and 5% less than 16. younger patients also had a more aggressive initial course. thirty-eight percent of patients had only taken salicylates during the disease course and were characterized by a lower incidence of systemic symptoms at presentation (3.8% versus 8.8%, p < 0.001), fewer extraintestinal manifestations (7.7% versus 24.0%, p < 0.001), and a higher prevalence of proctitis (32.1% versus 10.0%).
Conclusions:
A more aggressive phenotype was found in extensive colitis and in the initial course of younger patients, with an increased need for steroids and immunosuppressors. in addition, a significant percentage of patients, particularly with proctitis, showed a milder clinical evolution and were maintained in remission only with salicylates.