Background and aimsInflammatory bowel diseases (IBDs) and colorectal cancer have an increased impact on the Lebanese population’s morbidity and mortality. This study evaluated the situation of IBD and colorectal cancer at a tertiary hospital centre in Lebanon.Methods1007 patients underwent colonoscopy over a period of 12 months by qualified physicians. 91 patients were excluded from the study. Biopsy results were divided into normal versus abnormal colonic tissue. The abnormal section was further subdivided into number of polyps, IBD, dysplasia and cancer.ResultsOut of 916 individuals included, 61 cases of Crohn’s colitis (CC) (6.7%) and 24 cases of ulcerative colitis (UC) (2.7%) were identified. A total of 92 cases of colorectal cancer (10.04%) were also identified. There was a slight male predominance in both groups of IBD without any statistical significance. One statistical significance was reported in favour to age<50 years in both IBD groups with a mean age of 37.9±9.7 years and 34.4±6.4 years for CC and UC, respectively. The incidence of granuloma in the CC group was 8.9% without any correlation compared with age or gender. No correlation was made between colorectal cancer and the existence of any IBD type. The data showed that age >50 years and male gender significantly correlate with an increased incidence of precancerous and cancerous polyps in the colon. They significantly correlate with adenocarcinoma. The estimated incidence of colorectal cancer, CC and UC was 54.1, 35.8 and 14.1 per 100 000, respectively, with a denominator of 169 959 patients per year.ConclusionWithin the limitations of this study, the incidence of colorectal cancer and IBD falls in the high range compared with similar European and American studies. Our data are biased because of the tertiary centre setting but they can be considered as base for further investigations.

ObjectiveCorrea’s cascade is a ‘Model for Gastric Cancer Development’ described by Peleyo Correa. The reversibility of Correa’s cascade remains debatable. The literature contains insufficient data on the specific stage of the cascade during which Helicobacter pylori is detected, treated, and the effect on prognosis. Herein, we aim to determine the prevalence of various precancerous and cancerous gastric lesions in patients presenting with dyspepsia, the prevalence of gastritis and H. pylori infection, the prevalence of duodenal pathology in patients presenting with dyspepsia, identify the stage of H. pylori detection in relation to Correa’s cascade, and investigate a possible relationship between H. pylori and celiac disease.DesignRetrospective cross-sectional study conducted on a middle eastern population at a Lebanese tertiary hospital centre. 1428 patients presenting with dyspepsia underwent gastroscopy with gastric and duodenal biopsies. Variables include age, sex, presence/absence of H. pylori infection, and histopathological analysis of gastric and duodenal biopsies.ResultsBeing above 40 years of age was associated with increased likelihood of exhibiting abnormal gastric biopsy result. Gastritis and metaplasia were detected more frequently than glandular atrophy (p<0.001) with gastritis being present the most (p<0.001). The presence of H. pylori and the gastric biopsy results were not associated with any of the duodenal biopsy results.ConclusionThe burden of H. pylori infection in patients with dyspepsia was high. H. pylori was detected at various precancerous lesions with varying significance. The prevalence of duodenal adenocarcinoma in dyspeptic patients is unexpectedly high. No association between gastric and duodenal pathologies was found.

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Background Inflammatory bowel disease (IBD) has a lengthy natural history with significant symptomatic impacts. Crohn’s disease (CD) and Ulcerative colitis (UC) both have a major impact on patient Health Related Quality of Life (HRQoL). This study aims to evaluate the postulated negative effect of IBD on HRQoL in the Lebanese population. Methods Cross sectional data was collected from a group of, 55 Lebanese patients with IBD (43 with CD and, 12 with UC). Demographic and disease-related data were recorded. Health Related Quality of Life was assessed by disease-specific and generic questionnaires, Inflammatory Bowel Disease Questionnaire (IBDQ) and Short Form Health Survey (SF-36), respectively. Disease activity was assessed based on Harvey-Bradshaw Index (HBI) and the Colitis Activity Index (CAI) for CD and UC patients, respectively. Results IBD resulted in sub-optimal scores in both IBDQ-32 and SF-36, especially in UC patients (mean IBDQ-32 of, 174.8 [UC]vs, 208.8 [CD]; P&lt;0.01 and mean SF-36 of, 111.4 [UC] vs, 130.3[CD]; P&lt;0.05) and in patients classified in the increased disease activity group “Severe symptoms” (P&lt;0.01 for both questionnaires). In addition, only IBDQ-32 scores were significantly decreased for patients classified in the long disease duration group “&gt;60 months” (P&lt;0.05). Last but not least, treatment modality had a significant relation to HRQoL for all studied treatment subtypes. Conclusion Health Related Quality of Life in Lebanese patients is negatively impacted by IBD, but relatively to a lesser degree than what has been previously reported from other countries using IBDQ questionnaire as an assessment tool. More specifically, patients with UC, longer disease duration and higher disease activity have an increased negative impact on HRQoL. Treatment modality had significant relation to HRQoL, but larger scale studies are still needed to reach more reliable conclusions.