Inflammatory Bowel Disease Outcomes in Northern Iran: A Retrospective Cohort Study of Remission, Complications, and Treatment Strategies

Background Inflammatory bowel disease (IBD), encompassing Crohn′s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory condition affecting the gastrointestinal tract. While significant progress has been made in managing IBD, the long‐term outcomes remain heterogeneous, prompting this cohort study. Methods A retrospective analysis was performed on patients with IBD registered between 2000 and 2023. Clinical data, including demographics, disease activity, remission rates, therapeutic approaches, and complications, were collected. Results Among 600 enrolled patients, 72.8% were diagnosed with UC. Both patients with UC and those with CD showed improvements in endoscopic severity by the end of follow‐up ( p < 0.001). Clinical remission was achieved by 96.3% of patients with UC and 91.2% of those with CD during the last 6 months of follow‐up ( p = 0.046). Disease progression occurred in 22.1% of patients with CD and 18% of those with UC ( p = 0.100). Gastrointestinal complications were more prevalent in patients with CD (25.6% vs. 1.6%, p < 0.001). Relapse remained high, with 86.7% of patients with UC and 92.6% of those with CD experiencing relapses at least once during follow‐up, particularly those with severe baseline disease ( p < 0.01). Biologic therapies were used more frequently ( p < 0.01) and initiated earlier in patients with CD ( p = 0.031). Conclusion The study showed significant clinical improvement, yet many patients, particularly those with severe initial disease, had incomplete remission and frequent relapses, necessitating more effective long‐term management strategies. The distinction between CD and UC highlights the need for specialized treatments.