P656 Otorhinolaryngologic manifestations in Inflammatory Bowel Disease - Pilot study
A. Oliveira*1, J.C. Ribeiro2, P. Freire1, M. Ferreira1, F. Portela1, C. Sofia1
1Coimbra Hospital and University Centre, Gastroenterology, Coimbra, Portugal, 2Coimbra Hospital and University Centre, Otorhinolaryngology, Coimbra, Portugal
Extraintestinal manifestations are often found in inflammatory bowel disease (IBD), mainly affecting the skin, eyes, joints and the hepatobiliary and renal systems. Some sporadic cases of otorhinolaryngologic manifestations were reported in patients with IBD however the real incidence and prevalence of these disorders have not been described. The objective of this study is to determine the prevalence of otohinolaryngologic manifestations in patients with IBD and to evaluate a possible correlation with the activity/progression of the disease.
We performed a prospective study of patients with ulcerative colitis or Crohn's disease that were referred to Otorhinolaryngology consultation with structured clinical assessment. We excluded patients with other systemic autoimmune diseases, hearing pathology, acoustic trauma and history of ear surgery. We used the Montreal Classification for disease characterization and the Harvey-Bradshaw Index or the Montreal Classification for the Crohn's disease or ulcerative colitis activity, respectively. We consider the normal tympanometric values between 0.3-1.4 cc.
We included 25 patients, 14 with ulcerative colitis and 11 with Crohn's disease. Thirteen females and twelve males with a mean age of 40 ± 11 years. The mean duration of the disease was 10 ± 7 years. It was observed that the compliance of the ear was increased in 48% of patients, with a mean of 2.0 ± 2.6 cc. It was established the presence of tinnitus in 7 patients (28%), laryngeal ulcers in 4 (16%), nasal crusts in 4 (16%) and anterior septal perforation in 3 (12%). No relationship was found between the findings and the type or activity of the disease, presence of autoantibodies, other extraintestinal manifestations and medication.
There is a significant disturbance in the function of the middle ear as well as an increased frequency of tinnitus compared to the general population (14%). Despite the limitations imposed by the sample size, these preliminary data suggest that audiologic assessment in patients with IBD should be performed routinely.