Racial Differences in Disease Extent and Severity in Patients with Ulcerative Colitis: A Retrospective Cohort Study

Introduction Ulcerative colitis (UC) is increasing in African-Americans (AA). The objectives of this study were to assess disease extent and severity in UC by race. Methods Disease extent and severity was assessed in UC outpatients evaluated at the University of Maryland and Baltimore VA from 1997 to 2005. Results About 197 patients were identified; 47 were AA (23%). Of AA, 23% had proctitis, 23% had left-sided colitis, and 53% had extensive colitis compared to 10%, 31%, and 59% of Caucasians, respectively (P = 0.056). African-Americans were less likely to ever receive steroids (45% versus 62%; P = 0.065), be treated with ≥2 courses of steroids (54% versus 68%; P = 0.242) or be steroid dependant (33% versus 46%; P = 0.304). After adjustment, only female gender (OR 0.32, [0.16–0.66]) and age at diagnosis (OR 2.50, [1.28–4.90]) were associated with extensive colitis. Being seen at UMMS (OR 5.10, [2.60–10.10]) was associated with steroid use. Conclusion Race was not associated with extent of colitis or disease severity in UC.