The Montreal classification system of inflammatory bowel disease (IBD) provides a framework for describing disease phenotype.
Dr Kelly Tarrant and colleagues from New Zealand described changes in inflammatory bowel disease (IBD) phenotype using the Montreal system, and determined predictors of phenotype change in a Caucasian population-based cohort.
The team recruited 90% of people with inflammatory bowel disease.
Clinical notes were reviewed to confirm diagnosis and phenotype.
Determinants of phenotype change were analyzed using multivariate analysis.
The researchers evaluated a total of 1420 patients with IBD.
|73% of Crohn's patients had inflammatory disease at diagnosis|
|American Journal of Gastroenterology|
Median follow-up was 7 and 11 years for Crohn's disease and ulcerative colitis, respectively.
Disease location remained stable in 91% of those with Crohn's disease.
The research team noted that 73% of Crohn's disease patients had inflammatory disease at diagnosis with the proportion of patients with complicated disease increasing over time.
The team found progression to complicated disease was more rapid in those with small bowel than colonic disease location.
Perianal disease was a significant predictor of change in Crohn's disease behavior.
Younger ulcerative colitis patients were more likely to have extensive disease at diagnosis than older patients.
Dr Tarrant’s team concluded, “Although Crohn's disease location remains relatively stable, behavior changes over time.”
“Perianal disease is a strong predictor of developing more complicated Crohn's disease.”
“Proctitis is most common in ulcerative colitis patients at diagnosis although younger patients are more likely than older patients to have extensive disease.”
“The Montreal classification provides a clinically useful framework for both researchers and clinicians.”