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Crohn's disease in the Singapore Chinese population
Insights
The prevalence of Crohn's disease (CD) is rising in Singapore's Chinese population, with clinical features mirroring Western cases. Most patients responded to standard medical therapy, though long-term outcomes require further assessment.
Area of Science:
- Gastroenterology
- Epidemiology
- Internal Medicine
Background:
- Crohn's disease (CD) is historically rare in Asian populations.
- An increasing trend of CD has been observed in the Singapore Chinese population.
- Understanding this trend is crucial for public health and clinical management.
Purpose of the Study:
- To investigate the trend of Crohn's disease (CD) in the Singapore Chinese population.
- To analyze the clinical characteristics and outcomes of CD patients.
- To compare findings with previous studies from Singapore and Western populations.
Main Methods:
- Retrospective study of 32 Chinese CD patients from 1987-1993 at Singapore General Hospital.
- Disease activity assessed using the Organisation Mondiale de Gastroenterologie index.
- Comparison with a 1987 Singaporean series and a Western series.
Main Results:
- Hospital prevalence increased significantly from 3.5 to 26.7 per 100,000 patients.
- Common symptoms included bloody diarrhea, abdominal pain, weight loss, and fever.
- Relapses occurred in 26 patients, complicated by fistulas (8) and strictures (11).
Conclusions:
- The prevalence of Crohn's disease (CD) appears to be increasing among the Singapore Chinese.
- Clinical features are comparable to those observed in Western populations.
- Standard medical therapies showed good initial response, but long-term outcomes need continued monitoring.
Abstract:
Crohn's disease (CD) is rare in the Chinese population, but lately there seems to be an increasing trend of CD in the Singapore Chinese population. We carried out a retrospective study of all Chinese patients with CD seen from 1987 to 1993 at the Singapore General Hospital. All patients were regularly followed up and treated. Disease activity was defined by the Organisation Mondiale de Gastroenterologie index. We also compared our series with our first series reported in 1987 and a Western series. There were 32 patients (20 men, 12 women) giving a hospital prevalence of 26.7 per 100,000 patients compared with 3.5 per 100,000 patients in 1986. The mean age was 37.1 years (range, 19-80 years). Twelve patients had small intestinal disease, 9 had colonic disease, and 11 had both. The common presenting symptoms were bloody diarrhea (67%), abdominal pain (53%), loss of weight (47%), and fever (34%). Extraintestinal manifestations were rare. Six patients had no relapse during the follow-up period, whereas the remaining 26 patients had an average of two relapses (range, 1-5). These relapses were complicated by fistulas in 8 patients and strictures in 11 patients. Response to steroids and sulfasalazine was good in most patients. Four patients required repeated surgery despite medical treatment. The prevalence of CD appears to be increasing among the Singapore Chinese population. The clinical features are similar to those of the Western population. Most of our patients responded to standard medical therapy, but further follow-up is needed to assess their long-term clinical outcome.