INCIDENCE AND CHARACTERISTICS OF INFLAMMATORY BOWEL DISEASE IN BRUNEI DARUSSALAM.
Ong HL1, Idris FI1, Telisinghe PU2, Chong VH1, 3
1 PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, BE1410, Brunei Darussalam.
2 Department of Pathology, and 3 Department of Gastroenterology, Raja Isteri Pengiran Anak Saleha Hospital, Jalan Putera Al Muhtadee Billah, Bandar Seri Begawan, BA1710, Brunei Darussalam.
Introduction: The incidence of inflammatory bowel disease (IBD) is increasing worldwide. However, rates are much lower in the developing nations compared to the developed nations. This study assessed the incidence and characteristics of patients with IBD in Brunei Darussalam, a developing Southeast Asian nation with a predominantly Malay population. Materials and Methods: A total of 83 patients (41 males and 30 females) were diagnosed with IBD between 2004 and 2016. Clinical case notes were systematically reviewed and demographic data and presenting complaints were collected and analysed. Results: The overall number of cases of IBD remained small but incidence rates were increasing (0.28 per 100,000 population in 2004 to 3.08 per 100,000 population in 2016). Ulcerative Colitis (UC) (n=56, 67.5%) was more common than Crohns Disease (CD) (n=27, 32.5%) and both showed increasing rates over the 13-year period (UC; 0.28/100,000 population in 2004 to 1.66/100,000 population in 2016 and CD; 0/100,000 population in 2004 to 1.42/100,000 population). The overall mean age at diagnosis was 36.0 ± 17.2 years; UC 39.6 ± 17.6 years and CD 28.4 ± 13.9 years. At presentations, UC patients were more likely to present with bleeding per rectum (p<0.001), diarrhoea (p=0.003) and tenesmus (p=0.019) while CD patients were more likely to present with weight loss (p=0.008). In UC, extensive colitis (involvement proximal to splenic flexure) was seen in 32.7% and rectal sparing in 12.2%. In CD, 52.6% had ceacal involvements. Conclusions: Our study showed that IBD is increasing in Brunei Darussalam, more in UC than CD. The characteristics of our patients are similar to what have been reported. Age of diagnosis was older in UC than CD and although there are overlap, certain clinical presentations were common to each condition.
Keywords: Inflammatory bowel disease, Incidence, Crohn’s disease, Ulcerative colitis
Correspondence: Hui Ling ONG, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, BE1410, Brunei Darussalam.
Telephone: +673 8635142
Brunei Int Med J. 2018;14:120-127