P219. Inflammatory bowel disease in clinical practise: findings from a tertiary care center in Turkey
S. Hulagu1, G. Sirin1, O. Sentürk1, A. Celebi1, 1Kocaeli University, Gastroenterology, Kocaeli, Turkey
The incidence of inflammatory bowel disease (IBD) increases rapidly worldwide. Specialized consultations dedicated to their diagnosis, investigation, monitoring and treatment are essential. We aimed that to investigate the clinical aspects and treatment characteristics of patients with IBD.
Patients with IBD admitted between 1 March 2010 and 30 April 2012 in the Gastroenterology Department of Kocaeli University Medical Faculty Hospital, Turkey were enrolled in this study. Demographic, clinical and treatment data of these patients, followed in specialized consultation in this tertiary care hospital collected.
A total of 326 patients were correctly identified as having IBD. Of these, 210 (64.4%) had Ulcerative colitis (UC) and 116 (35.6%) had Crohn's disease (CD). 52% male, mean age 44.7 years (18–79). In CD: L1 30%, L2 12%, L3 58%, L4 isolated or in combination with other location 10%; B1 66%, B2 8%, B3 26%; perianal disease 18%. In UC: E1 30%, E2 42.4%, E3 27.6%. Globally 41.7% have extraintestinal manifestations (EIM), 56.8% are under immunosuppression (IS); 12% under biological therapy; 6.0% under combination therapy (12% in the past), 21% underwent surgery of the small intestine or colon. The average age is lower for CD than for UC (39 vs 50, p < 0.001) and the female gender is predominant in CD (56% vs UC 44%, p > 0.5). Patients with CD have EIM more often than those with UC (32.4% vs 19.8%, p < 0.001): are more often treated with IS (50.1% vs 21.4%, p < 0.001), with biological therapy (16.5% vs 5.6%, p < 0.001), currently with combination therapy (8.2% vs 2.9%, p = 0.003), combination therapy in the past (16.9% vs 3.8%, p < 0.001) and have a higher risk of being submitted to surgery (39.0% vs 6%, p < 0.001). A history of smoking was observed in 59.45% of CD patients and in 23% of UC patients. Apendicectomy and tonsillectomy were more frequent in the CD group (p = 0.05), while atopy in the UC group. The most frequent encountered extraintestinal complications were arthritis and erythema nodosum. 10% of the IBD patients underwent surgery for disease related complications.
In this study the clinical characteristics of CD and UC are similar to those described in medical literature, but the clinical course of the disease is different, with high rates of intestinal and extraintestinal complications. We emphasize the greater weight that CD has in the need of immunosuppessive and biological therapy as well as in the need of surgery.