Inflammatory bowel diseases in Indo-Canadians: PATIENTS AND METHODS
Patient groups: Each patient had an established diagnosis of idiopathic ulcerative colitis or Crohn’s disease in the small and/or large intestine based on clinical, radiological, endo- scopic and histological criteria, and negative microbiological studies. Ulcerative colitis was diagnosed when a diffuse inflammatory process involving the rectum and extending proximally within the colon was present. As in previously reported studies, disease extent and site were classified as ‘distal disease’ if inflammatory changes were localized in the distal 60 cm based on colonoscopic visualization as well as endoscopic mucosal biopsy, or as ‘extensive disease’ if inflammatory changes were over 60 cm. Crohn’s disease was diagnosed from colonoscopic and histological studies showing a segmental or patchy inflammatory process within the colorectum, distal small intestine or both, often with gran- ulomatous changes. In addition, the upper gastrointestinal tract was evaluated with the use of radiological, endoscopic and histological studies. Surgical material, if available, was also examined. During the course of this study, no other form of idiopathic IBD was observed, including the microscopic forms of colitis (lymphocytic or collagenous colitis).
All patients in this prospective study were of South Asian descent, residents of the metropolitan area of Vancouver, British Columbia, and seen by the investigator for clinical evaluation during the 46-month period fromJanuary 1995 to October 1998, inclusive. Of these 84 patients, 42 (50%) were newly referred and 42 (50%) were patients evaluated earlier from July 1979 to December 1994, and being followed in the author’s own clinical practice of adult patients. All patients in this study had serological samples collected sequentially with no exclusions or refusals; all were obtained from ambulatory patients.
For each patient, the age and year of the initial diagnosis of either ulcerative colitis or Crohn’s disease along with the clinical findings in each patient were recorded. This included site and extent of disease in the upper and lower gastrointestinal tracts, presence or absence of histologically defined granuloma, intestinal and extraintestinal complications including perianal disease, medical and surgical therapies, familial history of documented IBD and definition of postsurgical complications, including pouchitis in patients who had undergone a restorative pelvic pouch procedure after proctocolectomy for ulcerative colitis.
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