{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T02:53:36Z","timestamp":1783479216092,"version":"3.55.0"},"reference-count":41,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"abstract":"<jats:p>ABSTRACT  Background: Crohn\u2019s disease (CD) is a chronic inflammatory disease, with a heterogeneous clinical course, which can affect any segment of the gastrointestinal tract. Data on the natural history of CD in developing countries are rare.  Objective: to delineate the clinical, epidemiological, and longitudinal characteristics of CD patients at a Brazilian referral center.  Methods: this is an observational, cohort, retrospective study, carried out from the collection of data obtained from the medical records of individuals diagnosed with CD followed up in the period between 1991 and 2021.  Results: A total of 328 participants were included, 54.3% female. The median age at diagnosis was 31 years [interquartile range (IQR)=14-45]. At diagnosis, there was a predominance of the stricturing form (38.7%) and ileocolonic location (53.7%). Among the patients with the inflammatory form, 10.8% evolved to the stricturing or penetrating forms, and the time they remained with uncomplicated disease had a median of 6 years (IQR=0-13). Aminosalicylates were used in 70.7% of the patients, but there has been a reduction in their use in the last 15 years (P=0.04). Corticosteroids were used in 90.2% of the participants, with a median time of use of 12 months (IQR=0-36). Immunosuppressants were used in 93.9% of participants. Two hundred and ten patients (64%) received treatment with immunobiological. The median interval between diagnosis and initiation of biological therapy was 24 months (IQR=12-60). One hundred and eighty-nine patients (57.6%) were hospitalized during follow-up, and the median hospital stay was 20 days (IQR=11-36). In the last 15 years, there was a decrease in the hospitalization rate (P&lt;0.001), but there was no change in the number of hospitalizations per patient (P=0.62). One hundred and fifty-two patients (46.3%) underwent surgical treatment during the period evaluated and the most frequently performed surgeries were enterectomies (26.8%) and perianal procedures (25%). In the last 15 years, there has been a decrease in the rate of surgeries (P=0.04) and in the number of surgeries per patient (P&lt;0.001).  Conclusion: The data presented indicate a high prevalence of complicated CD at the onset of follow-up, alongside a significant percentage of corticosteroid use and hospitalization. However, over the past 15 years, there has been a notable reduction in hospitalization rates, surgical rates, and the number of surgeries per patient.<\/jats:p>","DOI":"10.1590\/s0004-2803.24612025-032","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T15:03:15Z","timestamp":1757084595000},"source":"Crossref","is-referenced-by-count":1,"title":["EPIDEMIOLOGICAL AND CLINICAL PROFILE OF CROHN\u2019S DISEASE IN A BRAZILIAN REFERRAL CENTER IN 30 YEARS OF FOLLOW-UP"],"prefix":"10.1590","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9447-7058","authenticated-orcid":false,"given":"Igor Nolasco","family":"SEGHETO","sequence":"first","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2338-5367","authenticated-orcid":false,"given":"Francisco Guilherme Cancella","family":"PENNA","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2118-1365","authenticated-orcid":false,"given":"Sophia Campos Salles Silva de","family":"CARVALHO","sequence":"additional","affiliation":[{"name":"Faculdade Ci\u00eancias M\u00e9dicas de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-5538","authenticated-orcid":false,"given":"Maria de Lourdes Abreu","family":"FERRARI","sequence":"additional","affiliation":[{"name":"Universidade Federal de Minas Gerais,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"key":"ref1","first-page":"73","article-title":"Landmark article Oct 15, 1932. Regional ileitis. A pathological and clinical entity. By Burril B. Crohn, Leon Ginzburg, and Gordon D","volume":"251","author":"Crohn BB","year":"1984","journal-title":"Jama"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"w14599","DOI":"10.4414\/smw.2018.14599","article-title":"New insights into the pathophysiology of inflammatory bowel disease: microbiota, epigenetics, and common signalling pathways","volume":"148","author":"Rogler G","year":"2018","journal-title":"Swiss Med Wkly"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1038\/ajg.2009.579","article-title":"The natural history of adult Crohn\u2019s disease in population-based cohorts","volume":"105","author":"Peyrin-Biroulet L","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1053\/j.gastro.2005.01.048","article-title":"Infliximab maintenance treatment reduces hospitalizations, surgeries, and procedures in fistulizing Crohn\u2019s disease","volume":"128","author":"Lichtenstein GR","year":"2005","journal-title":"Gastroenterology"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1053\/j.gastro.2004.01.063","article-title":"Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences","volume":"126","author":"Loftus Jr EV","year":"2004","journal-title":"Gastroenterology"},{"key":"ref6","doi-asserted-by":"crossref","DOI":"10.1053\/j.gastro.2011.10.001","article-title":"Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review","volume":"142","author":"Molodecky NA","year":"2012","journal-title":"Gastroenterology"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.vhri.2018.03.010","article-title":"Inflammatory Bowel Disease in Latin America: A Systematic Review","volume":"17","author":"Calderon M","year":"2018","journal-title":"Value Health Reg Issues"},{"key":"ref8","first-page":"18304","article-title":"Progression of Inflammatory Bowel Diseases Throughout Latin America and the Caribbean: a Systematic Review","author":"Kotze PG","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"423","DOI":"10.2147\/CEG.S176583","article-title":"Inflammatory bowel disease epidemiology in S\u00e3o Paulo State, Brazil","volume":"11","author":"Gasparini RG","year":"2018","journal-title":"Clin Exp Gastroenterol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/MOG.0000000000000534","article-title":"The globalization of inflammatory bowel disease: the incidence and prevalence of inflammatory bowel disease in Brazil","volume":"35","author":"Quaresma AB","year":"2019","journal-title":"Curr Opin Gastroenterol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1046\/j.1572-0241.2003.04010.x","article-title":"Remission in patients with Crohn\u2019s disease is associated with improvement in employment and quality of life and a decrease in hospitalizations and surgeries","volume":"99","author":"Lichtenstein GR","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1002\/ibd.20927","article-title":"Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn\u2019s disease","volume":"15","author":"Schnitzler F","year":"2009","journal-title":"Inflamm Bowel Dis"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1053\/j.gastro.2020.12.031","article-title":"STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD","volume":"160","author":"Turner D","year":"2021","journal-title":"Gastroenterology"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3109\/00365528909091339","article-title":"Classification of inflammatory bowel disease","volume":"170","author":"Lennard-Jones JE","year":"1989","journal-title":"Scand J Gastroenterol Suppl"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/ecco-jcc\/jjw168","article-title":"3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn\u2019s Disease 2016: Part 1: Diagnosis and Medical Management","volume":"11","author":"Gomollon F","year":"2017","journal-title":"J Crohns Colitis"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1136\/gut.2005.081950a","article-title":"European evidence based consensus on the diagnosis and management of Crohn\u2019s disease: definitions and diagnosis","volume":"55","author":"Stange EF","year":"2006","journal-title":"Gut"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"5a","DOI":"10.1155\/2005\/269076","article-title":"Toward an integrated clinical, molecular, and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology","volume":"19","author":"Silverberg MS","year":"2005","journal-title":"Can J Gastroenterol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.2174\/1389450115666140908125738","article-title":"Catching the therapeutic window of opportunity in early Crohn\u2019s disease","volume":"15","author":"Danese S","year":"2014","journal-title":"Curr Drug Targets"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2147\/CEG.S288688","article-title":"Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of S\u00e3o Paulo, Brazil","volume":"14","author":"Gomes TNF","year":"2021","journal-title":"Clin Exp Gastroenterol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.3748\/wjg.v21.i4.1197","article-title":"Inflammatory bowel disease in an underdeveloped region of Northeastern Brazil","volume":"21","author":"Parente JM","year":"2015","journal-title":"World J Gastroenterol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s12876-018-0822-y","article-title":"The prevalence and phenotype in Brazilian patients with inflammatory bowel disease","volume":"18","author":"Lima Martins A","year":"2018","journal-title":"BMC Gastroenterol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1053\/j.gastro.2010.06.070","article-title":"Risk factors associated with progression to intestinal complications of Crohn\u2019s disease in a population-based cohort","volume":"139","author":"Thia KT","year":"2010","journal-title":"Gastroenterology"},{"key":"ref23","first-page":"S","article-title":"Sa1842 - Delayed Diagnosis of Crohn\u2019s Disease is Common and Associated with an Increased Risk of Disease Complications","volume":"156","author":"Gallinger Z","year":"2019","journal-title":"Gastroenterology"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1186\/s12876-021-01938-8","article-title":"Impact of diagnostic delay to the clinical presentation and associated factors in pediatric inflammatory bowel disease: a retrospective study","volume":"21","author":"Sulkanen E","year":"2021","journal-title":"BMC Gastroenterol"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"6474","DOI":"10.3748\/wjg.v23.i35.6474","article-title":"Diagnostic delay in inflammatory bowel disease increases the risk of intestinal surgery","volume":"23","author":"Lee DW","year":"2017","journal-title":"World J Gastroenterol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.crohns.2014.01.023","article-title":"Diagnostic delay in a French cohort of Crohn\u2019s disease patients","volume":"8","author":"Nahon S","year":"2014","journal-title":"J Crohns Colitis"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1038\/ajg.2013.248","article-title":"Diagnostic delay in Crohn\u2019s disease is associated with a complicated disease course and increased operation rate","volume":"108","author":"Schoepfer AM","year":"2013","journal-title":"Am J Gastroenterol"},{"key":"ref28","series-title":"Modifica\u00e7\u00e3o do comportamento da doen\u00e7a de Crohn, baseada na classifica\u00e7\u00e3o de Montreal, em centro de refer\u00eancia brasileiro para tratamento de doen\u00e7as intestinais no per\u00edodo de 20 anos de acompanhamento","author":"Carvallho EB","year":"2012"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1053\/gast.2001.26279","article-title":"The natural history of corticosteroid therapy for inflammatory bowel disease: a population-based study","volume":"121","author":"Faubion WA","year":"2001","journal-title":"Gastroenterology"},{"key":"ref30","article-title":"Ethnicity Influences Phenotype and Outcomes in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis of Population-based Studies","volume":"16","author":"Shi HY","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1136\/gut.35.3.360","article-title":"Frequency of glucocorticoid resistance and dependency in Crohn\u2019s disease","volume":"35","author":"Munkholm P","year":"1994","journal-title":"Gut"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"487","DOI":"10.14309\/00000434-200709002-01004","article-title":"Hospitalization rates for Crohn\u2019s disease patients in Olmsted county, Minnesota in the pre-biologic era","volume":"102","author":"Ingle SB","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"ref33","first-page":"111","article-title":"Hospitalization of Patients with Crohn\u2019s Disease: A Systematic Review and Meta-analysis","volume":"22","author":"Niv Y","year":"2020","journal-title":"Isr Med Assoc J"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1186\/s12876-021-01781-x","article-title":"Hospitalization, and surgery rates in patients with inflammatory bowel disease in Brazil: a time-trend analysis","volume":"21","author":"Palacio FGM","year":"2021","journal-title":"BMC Gastroenterol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1007\/s00384-021-03930-w","article-title":"Crohn\u2019s disease: a population-based study of surgery in the age of biological therapy","volume":"36","author":"St\u00f6ss C","year":"2021","journal-title":"Int J Colorectal Dis"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1053\/j.gastro.2013.07.041","article-title":"Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies","volume":"145","author":"Frolkis AD","year":"2013","journal-title":"Gastroenterology"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1038\/ajg.2014.297","article-title":"Cumulative incidence of second intestinal resection in Crohn\u2019s disease: a systematic review and meta-analysis of population-based studies","volume":"109","author":"Frolkis AD","year":"2014","journal-title":"Am J Gastroenterol"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1038\/ajg.2018.27","article-title":"ACG Clinical Guideline: Management of Crohn\u2019s Disease in Adults","volume":"113","author":"Lichtenstein GR","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/ecco-jcc\/jjv213","article-title":"The First European Evidence-based Consensus on Extra-intestinal Manifestations in Inflammatory Bowel Disease","volume":"10","author":"Harbord M","year":"2016","journal-title":"J Crohns Colitis"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.gastrohep.2020.06.025","article-title":"Prevalence of mental disorder and impact on quality of life in inflammatory bowel disease","volume":"44","author":"Garc\u00eda-Alan\u00eds M","year":"2021","journal-title":"Gastroenterol Hepatol"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1080\/17474124.2021.1911644","article-title":"Burden of comorbid anxiety and depression in patients with inflammatory bowel disease: a systematic literature review","volume":"15","author":"Dubinsky MC","year":"2021","journal-title":"Expert Rev Gastroenterol Hepatol"}],"container-title":["Arquivos de Gastroenterologia"],"original-title":["Perfil epidemiol\u00f3gico e cl\u00ednico da doen\u00e7a de Crohn em um centro de refer\u00eancia brasileiro em 30 anos de seguimento"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0004-28032025000100603&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T15:03:21Z","timestamp":1757084601000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-28032025000100603&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":41,"alternative-id":["S0004-28032025000100603"],"URL":"https:\/\/doi.org\/10.1590\/s0004-2803.24612025-032","relation":{},"ISSN":["1678-4219","0004-2803"],"issn-type":[{"value":"1678-4219","type":"electronic"},{"value":"0004-2803","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e25032"}}