Inflammatory bowel disease cause-specific mortality: a primer for clinicians

Zain Kassam, Sara Belga, Idan Roifman, Simon Hirota, Humberto Jijon, Gilaad G. Kaplan, Subrata Ghosh, Paul L. Beck

Research output: Contribution to journalReview articlepeer-review

29 Citations (Scopus)
113 Downloads (Pure)


BACKGROUND: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC) is perceived to harbor significant morbidity but limited excess mortality, thought to be driven by colon cancer, compared with the general population. Recent studies suggest mortality rates seem higher than previously understood, and there are emerging threats to mortality. Clinicians must be up to date and able to clearly convey the causes of mortality to arm individual patients with information to meaningfully participate in decisions regarding IBD treatment and maintenance of health.

METHODS: A MEDLINE search was conducted to capture all relevant articles. Keyword search included: "inflammatory bowel disease," "Crohn's disease," "ulcerative colitis," and "mortality."

RESULTS: CD and UC have slightly different causes of mortality; however, malignancy and colorectal cancer-associated mortality remains controversial in IBD. CD mortality seems to be driven by gastrointestinal disease, infection, and respiratory diseases. UC mortality was primarily attributable to gastrointestinal disease and infection. Clostridium difficile infection is an emerging cause of mortality in IBD. UC and CD patients have a marked increase in risk of thromboembolic disease. With advances in medical and surgical interventions, the exploration of treatment-associated mortality must continue to be evaluated.

CONCLUSIONS: Clinicians should be aware that conventional causes of death such as malignancy do not seem to be as significant a burden as originally perceived. However, emerging threats such as infection including C. difficile are noteworthy. Although CD and UC share similar causes of death, there seems to be some differences in cause-specific mortality.

Original languageEnglish
Pages (from-to)2483-2492
Number of pages10
JournalInflammatory Bowel Diseases
Issue number12
Publication statusPublished - 2 Sept 2014


  • cause-specific mortality
  • inflammatory bowel disease
  • Crohn's disease
  • ulcerative colitis
  • mortality


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