{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T06:23:33Z","timestamp":1794464613543,"version":"4.9.1"},"reference-count":64,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Inflammatory bowel disease (IBD) is increasing in the Middle East and North Africa (MENA), yet region-specific evidence on phenotype and treatment patterns remains limited. We aimed to characterize IBD epidemiology, clinical phenotypes, and therapy use across MENA centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a multicenter cross-sectional study across 13 centers in seven MENA countries. Adults with ulcerative colitis (UC), Crohn\u2019s disease (CD), or IBD-unclassified (IBD-U) were included. Demographics, Montreal phenotype\/behavior, smoking status, disease duration, perianal disease, and therapies were collected. Descriptive statistics and between-group comparisons were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed 10\u2009340 patients (52% UC, 45% CD, 3% IBD-U). Mean age was 39.79\u2009\u00b1\u200914.4\u2009years in UC and 34.57\u2009\u00b1\u200912.9\u2009years in CD (P\u2009&amp;lt;\u2009.0001). UC patients were slightly more often female (51.6%), while CD patients were male-predominant (59.0%). Current smoking was more common in CD than in UC (12.0% vs 5.6%). Mean disease duration was 9.73\u2009\u00b1\u20097.5\u2009years, longest in Jordan (14.1\u2009years) and shortest in Qatar (2.45\u2009years; P\u2009&amp;lt;\u2009.001). Biologic exposure differed by subtype (P\u2009&amp;lt;\u2009.001), with the highest rate in CD (57.9%). In UC, extensive colitis (E3) was the most common phenotype. In CD, ileocolonic involvement (L3) predominated with mainly non-stricturing, non-penetrating behavior (B1). Perianal disease affected approximately 13% overall, with rates varying by country, highest in UAE and lowest in Egypt and Qatar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This multi-country hospital-based registry study helps define contemporary IBD patterns in MENA: slight UC predominance, high rates of extensive UC and ileocolonic B1 CD, and heterogeneous biologic use. Our data provide insights into regional IBD epidemiological trends and treatment adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjag145","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:49:16Z","timestamp":1788954556000},"source":"Crossref","is-referenced-by-count":1,"title":["Epidemiology of inflammatory bowel disease in the Middle East and North Africa: a multinational, tertiary care registry (MIRAGE) study"],"prefix":"10.1093","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2084-3956","authenticated-orcid":false,"given":"Mohammad","family":"Shehab","sequence":"first","affiliation":[{"name":"Program of Medicine, College of Medicine and Health Sciences, Abdullah Al Salem University , Khaldiya,","place":["Kuwait"]},{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, McGill University Health Center , Montreal,","place":["Canada"]},{"name":"Division of Gastroenterology, 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Alfaisal University , Riyadh,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem M","family":"AlShihri","sequence":"additional","affiliation":[{"name":"College of Medicine, Alfaisal University , Riyadh,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Mukhtar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University , Jeddah,","place":["Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Saadah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, King Abdulaziz University , Jeddah,","place":["Saudi Arabia"]},{"name":"Inflammatory Bowel Disease Unit, King Abdulaziz University Hospital , Jeddah,","place":["Kingdom of Saudi 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Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Alexandria,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman A","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Alexandria University, Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Alexandria,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha","family":"Maher","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Mansoura Facility of Medicine, Mansoura University , Mansoura,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gehad","family":"Daba","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Mansoura Facility of Medicine, Mansoura University , Mansoura,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed 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