Clinical epidemiology of Crohn's disease in Arabs based on the Montreal classification

Background: There has been a remarkable increase in the incidence of Crohn's disease (CD) among Arabs in recent years. We conducted this study to determine the clinical epidemiology of CD in Kuwait. Methods: Sociodemographic and clinical information was collected for a continuous series of 206 Arab patients with CD and age at diagnosis and location and behavior of disease was determined according to the Montreal Classification. Results: Among the 206 patients, 100 (48.5%) were males and 106 (51.5%) females. The mean age at diagnosis (+/- SD) was 21.9 +/- 10 years. Family history of CD was reported by 39 (18.9%) patients. The disease was limited to the ileum in 115 (55.8%) patients, whereas in 28 (13.6%) it involved the colon and in 63 (30.6%) it involved both the ileum and colon. The behavior of the disease was nonstricturing, nonpenetrating in 146 (70.9%) patients, whereas 49 (23.8%) had stricturing and 11 (5.3%) penetrating disease. Perianal disease was present in 41 (19.9%) patients. In the multivariate analysis, the use of biologic therapy and duration of the disease for =6 years were significantly associated with the presence of perianal disease, and the need for surgery was significantly associated with stricturing and penetrating disease behavior. Conclusions: CD among Arabs is equally common in males and females, presents at a relatively younger age, and in about half of the patients is limited to the small bowel. These features may indicate an underlying genetic predisposition for the disease in this population, which needs further investigation. (Inflamm Bowel Dis 2012;)