Characteristics, Complications, Comorbidities, and Other Manifestations of Inflammatory Bowel Disease: A 7-Year Tertiary Center Experience

<b>Background/Objectives</b>: Inflammatory bowel disease (IBD) is associated with significant morbidity worldwide. While global epidemiological trends are well-documented, data on the clinical and demographic characteristics of IBD patients in Saudi Arabia remain limited. This study aimed to evaluate the distribution of multimorbidity among IBD patients in a tertiary Saudi hospital and assess associated clinical features and outcomes. <b>Methods</b>: A retrospective cross-sectional study of IBD patients treated at the National Guard Hospital over a seven-year period was conducted. Data on demographics, body mass indices (BMIs), hospitalizations, comorbidities, complications, and surgical interventions were extracted from medical records. Associations between categorical and continuous variables were analyzed using chi-square and t-tests, respectively, with significance being set to <i>p</i> < 0.05. <b>Results</b>: A total of 465 patients were included: 54.6% had Crohn's disease (CD) and 45.4% had ulcerative colitis (UC). CD predominated in males (60.6%), while UC was more common in females (55.5%, <i>p</i> = 0.001). BMI distribution differed significantly between groups (<i>p</i> = 0.004). Hospital admission rates and length of stay were higher among CD patients (<i>p</i> = 0.032). CD patients experienced greater complication rates, including fistulas (41.3% vs. 7.1%, <i>p</i> < 0.001) and strictures (26.1% vs. 1.4%, <i>p</i> < 0.001). Surgical interventions such as fistulotomy (4.3% vs. 0.5%, <i>p</i> = 0.009) and stricturoplasty (9.1% vs. 1.9%, <i>p</i> = 0.001) were more frequent in patients with CD. <b>Conclusions</b>: This study characterizes IBD patients in Saudi Arabia, highlighting gender differences, BMI variations, and the greater severity of CD compared with UC. The higher rates of complications and surgical interventions among CD patients emphasize the need for tailored management strategies. Future prospective studies are warranted to investigate disease progression and optimize care for this population.