Clinical uniformity of inflammatory bowel disease at presentation and during the first year of disease in the north and south of Europe

Objective: To compare the methods used for diagnosis and the clinical features of non-specific inflammatory bowel disease (IBD) in the north and south of Europe. Design: A prospective study over 2 years in 1991-3 at eight centres in the north and 12 in the south of Europe, using the same criteria for disease definition and same protocol for recording data. Setting: Specialist gastroenterological centres with good diagnostic facilities at which every effort was made to ascertain all new cases of IBD seen in other departments and primary care in a defined geographical area of known population. Participants: A total of 2201 patients newly diagnosed as suffering from IBD, 1397 with ulcerative colitis (UC), 706 with Crohn's disease (CD) and 116 with indeterminate colitis (IND). Results: Diagnostic methods used were similar in north and south, a biopsy or resection specimen was available for examination in 94 and 95% of cases of UC and 92 and 87% of CD in north and south, respectively. The type, clinical presentation, site and extent of disease were similar in north and south. Treatment followed a common pattern and mortality from IBD was low in the first year after diagnosis. In both areas, age of onset of UC tended to be later than CD. Conclusion: The standard of diagnosis and clinical features of IBD are similar in specialist centres throughout Europe so providing a valid basis for this aspect of collaborative epidemiological or other studies.