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P222 The onset of clinical manifestations in patients with inflammatory bowel disease

V. Nóbrega1, J. Silva1, B. Brito1, I. Silva1, M. C. Silva1, A. Pimentel2, F. Fortes2, B. C. da Silva*3, 4, N. Almeida2, N. Almeida2, V. Surlo2, J. Mota2, G. Santana1

1Universidade do Estado da Bahia, Medicine, Salvador, Brazil, 2Roberto Santos General Hospital, Gastroenterology, Salvador, Brazil, 3Federal University of Bahia, Gastroenterology, Salvador, Brazil, 4Hospital da Bahia, Gastroenterology, Salvador, Brazil


Inflammatory bowel disease (IBD) is a group of diseases characterised by chronic inflammation of the gastrointestinal tract that includes mainly Crohn’s disease (CD) and ulcerative colitis (UC), whose initial symptoms may be quite variable. The objective was to analyse the onset of clinical manifestations in patients with CD and UC.


The study was a cross-sectional, descriptive, observational study. The data were collected from interviews and review of medical records. The following variables were included: nausea, vomiting, abdominal pain, diarrhoea, urgency and faecal incontinence, tenesmus, abdominal distension, presence of blood and mucus in stools, anaemia, weight loss, loss of appetite, malnutrition, fever, asthenia, insomnia, abdominal mass, oral aphtous ulcers, and perianal disease.


In total, 95 patients were included (44 CD and 51 UC); 68.4% were female. The average age at diagnosis was 34.3 years for CD (SD = 13.7) and 36.7 for UC (SD = 11.4). The most frequent symptoms in CD patients were weight loss (95.5%), diarrhoea (88.6%), abdominal pain (84.1%), asthenia (81.8%), faecal urgency (75%), malnutrition (70.5%), loss of appetite (70.5 %), anaemia (66%), presence of blood in stools (59.1%), presence of mucus in stools (59%), tenesmus (54.5%), insomnia (54.5%), faecal incontinence (52.3%), perianal disease (50%); and fever (50%). The most frequent symptoms in UC patients were presence of blood in stools (94.1%), diarrhoea (84.3%), abdominal pain (82.4%), presence of mucus in stools (82.4%), faecal urgency (82.4%), weight loss (80.4%), asthenia (71%), tenesmus (62.7%), anaemia (55%), and loss of appetite (55%).


The initial symptoms were similar in CD and UC, but did show degrees of importance difference. In CD, weight loss, diarrhoea, and abdominal pain were the most frequent symptoms. We observed a high presence of asthenia, urgency, and faecal incontinence. In UC, as well as in DC, the more frequent initial symptoms were similar to those described by other centres. The presence of systemic symptoms such as weight loss, asthenia, anaemia, and loss of appetite was frequent in the onset of IBD. The recognition of the symptoms present in the initial clinical presentation of IBD is very important for early diagnosis of these diseases.