Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, Brazil
Tarcia Nogueira Ferreira Gomes, Fabio Silva de Azevedo, Marjorie Argollo, Sender Jankiel Miszputen, Orlando Ambrogini Jr Disciplina de Gastroenterologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, BrazilCorrespondence: Tarcia Nogueira F...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-03-01
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| Series: | Clinical and Experimental Gastroenterology |
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| Online Access: | https://www.dovepress.com/clinical-and-demographic-profile-of-inflammatory-bowel-disease-patient-peer-reviewed-article-CEG |
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| author | Gomes TNF Azevedo FS Argollo M Miszputen SJ Ambrogini Jr O |
| author_facet | Gomes TNF Azevedo FS Argollo M Miszputen SJ Ambrogini Jr O |
| author_sort | Gomes TNF |
| collection | DOAJ |
| description | Tarcia Nogueira Ferreira Gomes, Fabio Silva de Azevedo, Marjorie Argollo, Sender Jankiel Miszputen, Orlando Ambrogini Jr Disciplina de Gastroenterologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, BrazilCorrespondence: Tarcia Nogueira Ferreira Gomes Rua Percílio Neto, 131, Vila Gumercindo, CEP 04131-080, São Paulo-SP, BrazilTel +55 11 94991 3883Email tarcia.nogueira@gmail.comBackground: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract with an increasing incidence in developing countries.Purpose: To report clinical and demographic data of CD and UC at a referral center for inflammatory bowel disease (IBD) in São Paulo.Patients and Methods: We conducted a retrospective cross-sectional study on adult patients with established IBD. Demographic and clinical data were obtained by medical records analysis from the IBD Outpatient Clinic of EPM-UNIFESP, from October 1997 to October 2017.Results: Of 658 patients included, 355 had UC (54%) and 303 had CD (46%). UC was more prevalent in women than CD (219 [61.7%] vs 152 [50.2%], p=0.003). The median time between the onset of symptoms and diagnosis was 13 (5– 38) months, with a longer duration for CD patients. CD mostly affected the ileocolonic location (47.9%). CD patients with stricture, fistula and/or perianal disease (213/303, 70.3%) were younger at diagnosis, had a longer disease duration, higher rates of corticosteroid, immunomodulatory, and biological therapy, hospitalization, and referral to surgery, compared to patients without complication. Extensive colitis was the most common extension of UC (50.6%), which was more frequently associated with younger age at diagnosis, hepatobiliary disease, increased need for hospitalization, higher use of immunomodulatory, and biologic therapy, compared to patients with less extensive disease. In the last 5 years, CD patients were more frequently on biologic and/or immunomodulatory (70.9%) therapy, and UC patients often received salicylates (78.1%) and immunomodulatory (28.1%) treatments. There was a consistent reduction in salicylate usage for CD in the last 5 years compared to the total period of follow-up.Conclusion: Despite the increasing incidence, we highlight the diagnostic delay and a more complicated CD and extensive UC in this cohort, reflecting a high need for immunomodulatory and biological treatment, hospitalization, and surgery.Keywords: Crohn’s disease, epidemiology, inflammatory bowel disease, ulcerative colitis |
| first_indexed | 2024-12-22T11:41:55Z |
| format | Article |
| id | doaj.art-3dad46cad40c4ce6aea7977517eccd8e |
| institution | Directory Open Access Journal |
| issn | 1178-7023 |
| language | English |
| last_indexed | 2024-12-22T11:41:55Z |
| publishDate | 2021-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical and Experimental Gastroenterology |
| spelling | doaj.art-3dad46cad40c4ce6aea7977517eccd8e2022-12-21T18:27:15ZengDove Medical PressClinical and Experimental Gastroenterology1178-70232021-03-01Volume 149110263160Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, BrazilGomes TNFAzevedo FSArgollo MMiszputen SJAmbrogini Jr OTarcia Nogueira Ferreira Gomes, Fabio Silva de Azevedo, Marjorie Argollo, Sender Jankiel Miszputen, Orlando Ambrogini Jr Disciplina de Gastroenterologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, BrazilCorrespondence: Tarcia Nogueira Ferreira Gomes Rua Percílio Neto, 131, Vila Gumercindo, CEP 04131-080, São Paulo-SP, BrazilTel +55 11 94991 3883Email tarcia.nogueira@gmail.comBackground: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract with an increasing incidence in developing countries.Purpose: To report clinical and demographic data of CD and UC at a referral center for inflammatory bowel disease (IBD) in São Paulo.Patients and Methods: We conducted a retrospective cross-sectional study on adult patients with established IBD. Demographic and clinical data were obtained by medical records analysis from the IBD Outpatient Clinic of EPM-UNIFESP, from October 1997 to October 2017.Results: Of 658 patients included, 355 had UC (54%) and 303 had CD (46%). UC was more prevalent in women than CD (219 [61.7%] vs 152 [50.2%], p=0.003). The median time between the onset of symptoms and diagnosis was 13 (5– 38) months, with a longer duration for CD patients. CD mostly affected the ileocolonic location (47.9%). CD patients with stricture, fistula and/or perianal disease (213/303, 70.3%) were younger at diagnosis, had a longer disease duration, higher rates of corticosteroid, immunomodulatory, and biological therapy, hospitalization, and referral to surgery, compared to patients without complication. Extensive colitis was the most common extension of UC (50.6%), which was more frequently associated with younger age at diagnosis, hepatobiliary disease, increased need for hospitalization, higher use of immunomodulatory, and biologic therapy, compared to patients with less extensive disease. In the last 5 years, CD patients were more frequently on biologic and/or immunomodulatory (70.9%) therapy, and UC patients often received salicylates (78.1%) and immunomodulatory (28.1%) treatments. There was a consistent reduction in salicylate usage for CD in the last 5 years compared to the total period of follow-up.Conclusion: Despite the increasing incidence, we highlight the diagnostic delay and a more complicated CD and extensive UC in this cohort, reflecting a high need for immunomodulatory and biological treatment, hospitalization, and surgery.Keywords: Crohn’s disease, epidemiology, inflammatory bowel disease, ulcerative colitishttps://www.dovepress.com/clinical-and-demographic-profile-of-inflammatory-bowel-disease-patient-peer-reviewed-article-CEGcrohn’s diseaseepidemiologyinflammatory bowel diseaseulcerative colitis |
| spellingShingle | Gomes TNF Azevedo FS Argollo M Miszputen SJ Ambrogini Jr O Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, Brazil Clinical and Experimental Gastroenterology crohn’s disease epidemiology inflammatory bowel disease ulcerative colitis |
| title | Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, Brazil |
| title_full | Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, Brazil |
| title_fullStr | Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, Brazil |
| title_full_unstemmed | Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, Brazil |
| title_short | Clinical and Demographic Profile of Inflammatory Bowel Disease Patients in a Reference Center of São Paulo, Brazil |
| title_sort | clinical and demographic profile of inflammatory bowel disease patients in a reference center of s atilde o paulo brazil |
| topic | crohn’s disease epidemiology inflammatory bowel disease ulcerative colitis |
| url | https://www.dovepress.com/clinical-and-demographic-profile-of-inflammatory-bowel-disease-patient-peer-reviewed-article-CEG |
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