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World J Gastroenterol. Jun 7, 2010; 16(21): 2600-2603
Published online Jun 7, 2010. doi: 10.3748/wjg.v16.i21.2600
Do clinical factors help to predict disease course in inflammatory bowel disease?
Edouard Louis, Jacques Belaiche, Catherine Reenaers
Edouard Louis, Jacques Belaiche, Catherine Reenaers, Department of Gastroenterology, CHU Liège, and GIGA Research, Liège University, 4000 Liège, Belgium
Author contributions: Louis E, Belaiche J and Reenaers C reviewed the literature and wrote parts of the manuscript; everyone approved the final version.
Correspondence to: Edouard Louis, Professor, Department of Gastroenterology, CHU Liège, Liège University, 4000 Liège, Belgium. edouard.louis@ulg.ac.be
Telephone: +32-4-3667256 Fax: +32-4-3667889
Received: January 20, 2010
Revised: February 7, 2010
Accepted: February 14, 2010
Published online: June 7, 2010
Abstract

While therapeutic strategies able to change the natural history of the disease are developing, it is of major importance to have available predictive factors for aggressive disease to try and target these therapeutic strategies. Clinical predictors have probably been the most broadly studied. In both Crohn’s disease (CD) and ulcerative colitis (UC), age at diagnosis, disease location and smoking habit are currently the strongest predictors of disease course. A younger age at onset is associated with more aggressive disease both in CD and UC. Disease location in CD is associated with different types of complications: surgery and recurrence in upper gastrointestinal and proximal small bowel disease; and surgery in distal small bowel disease and peri-anal lesions in rectal disease. In UC, extensive colitis is clearly been associated with more severe disease. Finally, active smoking globally increases disease severity in CD but decreases it in UC. Besides these important factors, others may predispose to some specific disease evolution and complications, and are also reviewed in the present paper.

Keywords: Crohn’s disease; Ulcerative colitis; Clinical predictors