P216 Natural course of inflammatory bowel disease in a Turkish cohort: a single tertiary centre experience in Ankara (2006–2015)
I. Yuksel*1, 2, Y. Coskun1, H. Akinci1, M. Hamamci1, E. Erarslan1, Y. Ustun1, Z. Simsek1, S. Coban1
1Diskapi Yildirim Beyazit Education and Research Hospital, Gastroenterology, Ankara, Turkey, 2Yildirim Beyazit University School of Medicine, Gastroenterology, Ankara, Turkey
In this study, we aimed to describe the natural course of inflammatory bowel disease (IBD) in Turkish adult patients during the past decade.
The medical records of patients with IBD referred to an adult tertiary gastroenterology unit from August 2006 to November 2015 were reviewed. Upper GI involvement was revealed with magnetic resonance (MR) enterography. Severity was assessed as need for hospitalisation, biological therapy, and surgery.
In total, 508 adult patients with IBD (317 male, 62.4%) with a mean age at diagnosis of 39.73 ± 13.49 years (range 16–84 years) were included. Ulcerative colitis (UC) was diagnosed in 304 patients (59.8%), with proctitis in 82 (26.9%), left sided in 133 (43.8%), and extensive in 89 (29.3%). Crohn’s disease (CD) was diagnosed in 180 patients (35.4%), with ileal in 79 (43.9%), colonic in 8 (4.4%), ileocolonic in 93 (51.7%), and combined with upper GI involvement in 30 (16.7%). Non-stenosing non-penetrating disease was found in 147 (81.7%), stenosing in 12 (6.7%), penetrating in 21 (11.7%), perianal disease in 31 (17.2%), and IBD undetermined (IBDU) in 24 (4.7%). Active smokers numbered 69 (38.3%) in the CD group and 27 (8.9%) in the UC group. In patients with CD, azathiopurine (n 64, 35.56%) has been most used for maintenance of remission, and in UC mesalazine enema (n 162, 53.29%) and mesalazine oral (n 148, 48.68%) have been used.
Severity indicators in patients with CD and UC were as follows: hospitalisation in 67 (37.22%) and 37 (12.17%), biological therapy in 22 (12.22%) and 3 (0.99%), and surgery in 22 (12.22%) and 2 (0.66%), respectively.
Trends in disease onset were investigated by division of the cohort into 2 sub-groups according to date of diagnosis: Group A, 2006–2010 and Group B, 2011–2015. For both CD and UC, patient numbers were greater in the latter group, going respectively from 42 (23.33%) to 138 (76.67%), and from 100 (32.89%) to 204 (67.11%). In patients with CD, hospitalisation rates increased, going from 9 (21.43%) in the first 5 years to 53 (38.41%) in the second 5 years, as did biological therapies, which went from 0 to 21 (15.22%). Surgery in CD patients proportionally decreased, from 8 (19.05%) in the first 5 years to 14 (10.14%) in the second 5 years.
The course of IBD in Turkish patients appears to be between that of Europe and that of Asia. Rates of disease onset have increased for both CD and UC. In patients with CD, the needs for biologic therapy and hospitalisation have increased, whereas surgery rates have decreased. More recent cases of IBD, especially CD, appear to be more challenging.