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P294 Clinic features and the prognosis of colonic Crohn’s disease

D. Ozgur1, A.I. Hatemi2, Y. Erzin2, A. Çelik2

1Department of Internal Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey, 2Department of Gastroenterology, Istanbul University-Cerrahpasa, Istanbul, Turkey

Background

In this study, we aimed to investigate the prognosis of colonic Crohn’s disease (CD) and to compare colonic CD with ileocolonic CD.

Methods

This study included 63 patients with colonic CD who were followed at least 1 year. The same number of patients with ileocolonic CD whose age of diagnosis and sex were similar to colonic CD patients were included in the study. Data about demographics, serological, clinic characteristics, medical treatment, surgical treatment requirements and complications during follow-up were obtained retrospectively from patient files.

Results

The files of 1289 CD patients who were followed up at a clinic of inflammatory bowel disease of Cerrahpaşa School of Medicine were scanned. There were 63 patients with colonic CD. Control group was formed as it was noted in the Methods section. The rate of patients who smoked was lower in colonic CD (47.6% vs. 65%, p = 0.048). ASCA positivity was higher in patients with ileocolonic CD (80% vs. 33.4%, p = 0.027). At the time of diagnosis, 87.3% of colonic CD patients and 65% of ileocolonic CD patients had inflammatory phenotype (p = 0.003). During follow-up, stenosis and penetrating disease development were more common in patients with ileocolonic disease (46% vs. 15.8%, p = 0.001). The rate of abdominal surgery was lower in colonic CD (11% vs. 38%, p = 0.001). Hospitalisation rate was less in colonic CD than ileocolonic CD (36.5% vs. 57%, p = 0.02). In colonic CD, use of azatioprine was less than ileocolonic CD and the number of patients treated with oral mesalazine monotheraphy is higher than ileocolonic CD. Endoscopic remission was higher in colonic CD (%61 vs. %28, p = 0.001).

Conclusion

The results of our study showed that colonic CD has different phenotype characteristics, treatment response and laboratory features than ileocolonic Crohn’s disease. Colonic CD has a lower penetrating and/or stenosing phenotype rate than ileocolonic CD. Surgery and hospitalisation were less common in patients with colonic Crohn’s disease. In addition, patients with colonic CD have a higher endoscopic remission rate. For these reasons, we conclude that colonic Crohn’s disease has a better prognosis than ileocolonic Crohn’s disease.