Do patients with ulcerative colitis diagnosed at a young age have more severe disease activity than patients diagnosed when older?

Background/Aims: To compare the clinical features and disease behavior of ulcerative colitis (UC) according to the age at onset. Methods: This retrospective study included 455 patients with UC who were diagnosed and treated between 1990 and 2008 at a single tertiary institution in Korea. The patients were divided into 2 groups according to their age at diagnosis of UC: an elderly group (≥40 years) and a young group (<40 years). Clinical findings at diagnosis, extent of disease, treatment modalities used, cumulative admission rates, cumulative relapse rates, and surgery rates were analyzed according to these age groups. Results: Two hundred and forty-two patients with UC (53.2%) were diagnosed before the age of 40 years. Disease severity at initial presentation as assessed by diarrhea frequency, the presence of pancolitis, and the use of steroids were higher in the young group; however, clinical disease course including cumulative admission rates, cumulative relapse rates, and surgery rates were not significantly different between the 2 groups. Conclusions: Certain clinical features and the extent of disease in UC patients appear to be more severe when the disease is diagnosed at younger age; however, their disease course and prognosis might not be different from those of their older counterparts.