Crohn's disease: influence of age at diagnosis on site and clinical type of disease

Gastroenterology. 1996 Sep;111(3):580-6. doi: 10.1053/gast.1996.v111.pm8780560.


Background & aims: Crohn's disease has a bimodal age distribution of disease onset diagnosis. The peaks (20 and 50 years) may represent different phenotypes or different genetic and/or environmental influences between younger- and older-onset individuals. The aim of this study was to examine the influences of age at diagnosis of Crohn's disease on disease site, type, and course.

Methods: Records of 552 consecutive patients with Crohn's disease were reviewed retrospectively.

Results: Younger age at diagnosis (younger than 20 years), compared with an older age (40 years or older), was associated with a greater prevalence of a family history of Crohn's disease (29.9% vs. 13.6%), greater small bowel involvement (88.7% vs. 57.5%), more stricturing disease (45.8% vs. 28.8%), and a higher frequency of surgery (70.6% vs. 55.3%). Older age at diagnosis was associated with a greater prevalence of colonic disease (84.8% vs. 71.2%) and the inflammatory subtype (54.5% vs. 34.4%). A conditional logistic regression analysis confirmed an independent effect of age at diagnosis on ileal disease and surgery for intractable disease.

Conclusions: In Crohn's disease, early age at diagnosis is associated with more complicated disease and a greater likelihood of having affected relatives. Stratification of Crohn's disease by age at diagnosis provides support for the concept of genetic heterogeneity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Crohn Disease / classification*
  • Crohn Disease / epidemiology*
  • Crohn Disease / genetics
  • Crohn Disease / surgery
  • Family Health
  • Female
  • Humans
  • Male
  • Medical Records
  • Regression Analysis
  • Retrospective Studies