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Background: Crohn′s disease is being increasingly reported from Saudi Arabia and information about its pattern is still accumulating. Aim of the study: To describe and classify the disease and assess the response to therapy in patients referred to a tertiary care centre in Gassim region, Kingdom of Saudi Arabia (KSA). Patients and Methods: Fifteen Saudi patients found to have Crohn′s disease over an eight-year period were studied. The presenting symptoms, area of involvement and the response to therapy were assessed. Results: There were five males and ten females. The age of 14 patients was less than 40 years. Symptoms had existed for more than one year before diagnosis in 14 patients. Common symptoms were diarrhea, pain during defecation, blood in stool and weight loss. The ileum was involved in three patients, the colon in four and the involvement was ileocolonic in eight patients. The behavior of the disease was non-stricturing nonpenetrating in eight, stricturing in two, penetrating in one and stricturing as well as penetrating in four patients. Three patients presented as acute appendicitis, four as intestinal obstruction and five with perianal disease. Histological diagnosis was possible in 12 patients. Thrombocytosis was present in seven patients and three had episodes of deep vein thrombosis. Eight patients responded to medical therapy. Surgical intervention was necessary in seven patients and three had multiple operations. One patient died during a median follow-up period of 18 months (range: 6 months to 8 years). Conclusion: Crohn′s disease occurs more commonly in young Saudi females. Patients are symptomatic for almost a year prior to diagnosis. The presentation is variable and response to therapy is satisfactory. Surgery is necessary in a high number of patients

Background: Ulcerative colitis (UC) is being reported more frequently among the Arabs. Information on the clinical severity, endoscopic and histological grading is scanty. Aim: To assess the severity of the disease and its response to therapy in patients referred to a tertiary care referral centre in Gassim region, Kingdom of Saudi Arabia (KSA). Patients and Method: Hospital records of thirty-four patients found to have UC from 1990-2002 were analyzed. The study included clinical severity, endoscopical and histological assessment, response to therapy and frequency of complications. Results: There were 21 males and 13 females with median age 35 (range: 18-76) years. The disease was clinically mild in seven patients (21%), moderate in 11 (32%) and severe in 16 (47%). Endoscopically UC was graded as 2 in three patients (9%), 3 in 21 patients (59%) and 4 in ten patients (29%). Histologically UC was mild to moderate in 11 patients (32%) and severe in 23 (68%). Extent of UC was total in nine patients (26%), up to transverse colon in six (18%), splenic flexure in 14 (41%), rectosigmoid region in four (12%) and only up to the rectum in one (3%). Twenty-nine patients (85%) were treated with salazopyrine and five patients (15%); (two of them were hypersensitive to salazopyrine) received 5-aminosalicylic acid. Proctocolectomy was performed in two with a focus of malignancy. No patient died during the median follow-up period of 48 months (range: 4 months to 12 years). Conclusion: Ulcerative colitis presented with varying severity, more frequently in males in the population studied. Most of the patients responded to salazopyrine and surgery was necessary when malignancy was detected