INFLAMMATORY BOWEL-DISEASE - A RETROSPECTIVE REVIEW OF A SPECIALIST-BASED COHORT

Objective: To study the morbidity and mortality of inflammatory bowel disease in Australia and whether it decreases life expectancy. Design: A retrospective review of patient case notes from two sydney teaching hospitals and the consulting rooms of the 17 gastroenterologists appo inted to these hospitals, examining all presentations with a diagnosis of inflammatory bowel disease from January 1977 to September 1992. Re sults: 997 cases were identified: 533 with ulcerative colitis, 417 wit h Crohn's disease, and 47 with indeterminate colitis. In patients diag nosed from 1977 onwards (n = 730), no difference in survival was demon strated for inflammatory bowel disease overall, or any subgroup, or in males or females, as compared with an age- and sex-matched control po pulation. Gastrointestinal malignancies occurred in 19 cases (18 color ectal carcinoma and one cholangiocarcinoma). The most commonly encount ered problems were the use of immunosuppressants and the need for surg ery. Inflammatory bowel disease, particularly Crohn's disease, entails appreciable morbidity. Conclusion: Since 1977, despite a significant requirement for medical and surgical treatment in patients with inflam matory bowel disease, there has been no adverse effect on survival in a specialist-referred cohort as compared with the general population.