Gender-related differences in the clinical course of Crohn's disease

OBJECTIVE: The aim of this study was to analyze the clinical and epidemiolo gical differences between women and men affected by Crohn's disease. METHODS: The clinical course of 275 female Crohn's disease patients was com pared with that of 266 male patients. RESULTS: Mean age at onset of symptoms and at diagnosis was 25.7 yr versus 27.7 yr and 28.8 yr versus 30.7 yr in women and men, respectively. Mean lag -time between onset of symptoms and establishment of the diagnosis were sim ilar in both groups, without differences in presenting symptoms and initial localization of lesions. In women, however, some extraintestinal manifesta tions of Crohn's disease were found to occur more often. The percentage of patients who underwent an abdominal operation was quite similar in both gro ups (81% vs 77%). Mean lag-time between onset of symptoms and first bowel r esection was not different. However, the lag-time between bowel resection a nd recurrence of disease was significantly shorter in women than in men (re spectively, 4.8 yr vs 6.5 yr, p = 0.04), particularly regarding primary ile ocecal resections. Overall, ileocecal resections were significantly more fr equently performed in female than male patients (44% and 32%, respectively, p = 0.004). Female patients were also found to have significantly more oft en relatives in the first or second degree affected by Crohn's disease than male patients (15% vs 8.3%, p = 0.02). CONCLUSIONS: Extraintestinal manifestations occur more often in female Croh n's disease patients than in male patients. Furthermore, an ileocecal resec tion, which is accompanied by an earlier recurrence, is more often performe d in female than in male patients. Female patients have more often relative s with the same disease. (C) 2001 by Am. Cell. of Gastroenterology.