Background Inflammatory bowel disease (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) imposes a significant burden on health-related quality of life, particularly in social domains. We sought to investigate the factors that limit social participation in patients with IBD. Methods We assessed a cohort of 239 Manitobans with IBD. We collected sociodemographic information, medical comorbidities, disease phenotype, symptom activity and psychiatric comorbidity (using the Structured Clinical Interview for DSM-IV). Participants completed the eight-item Ability to Participate in Social Roles and Activities (APSRA) questionnaire, which assesses participation restriction, including problems experienced in social interaction, employment, transportation, community, social and civic life. Results Poorer social participation scores were associated with earning less than $50,000 CAD income annually (P < 0.001), actively smoking (P = 0.006), higher symptom scores (P < 0.001 for CD, P = 0.004 for UC), and having an increasing number of chronic medical conditions (R = −0.30). History of depression (P < 0.001) and anxiety (P = 0.001) and having active depression (P < 0.001) and anxiety (P = 0.001) all predicted poor social participation scores. IBD phenotype or disease duration was not predictive. Based on multivariable linear regression analysis, significant predictors of variability in social participation were medical comorbidity, psychiatric comorbidity, psychiatric symptoms and IBD-related symptoms. Conclusions The factors that predict social participation by IBD patients include income, smoking, medical comorbidities, IBD symptom burden, and psychiatric comorbidities. Multivariable linear regression suggests that the most relevant factors are medical comorbidity, psychiatric comorbidity, psychiatric symptoms and IBD symptoms.

Background Inflammatory bowel disease (IBD) including Crohn’s disease (CD) and ulcerative colitis (UC) imposes a significant burden on health-related quality of life, particularly in social domains. We sought to investigate the factors that limit social participation in patients with IBD. Aims Our first aim was to identify if active IBD symptoms had an effect on an objective measure of social participation. Our secondary aim was to determine if psychiatric comorbidity and/or active psychiatric symptoms in IBD patients had an influence on social participation. Methods We assessed a cohort of 239 Manitobans with IBD. We collected sociodemographic information, medical comorbidities, disease phenotype, symptom activity and psychiatric comorbidity (using the Structured Clinical Interview for DSM-IV). Participants completed the 8-item Ability to Participate in Social Roles and Activities questionnaire, which assesses participation restriction, including problems experienced in social interaction, employment, transportation, community, social, and civic life. Results Poorer social participation score were associated with earning less than average income (p<0.001), being unemployed (p<0.001), actively smoking (p=0.006), higher symptom scores, and having an increasing number of chronic medical conditions (R= -0.296). History of depression (p<0.001) and anxiety (p=0.001) and having active depression (p<0.001) and anxiety (p=0.001) all predicted poor social participation scores. Patient’s with UC on 5-ASA (PO/PR) seem to have higher social participation than other therapies. Phenotype was not predictive. Based on multivariate linear regression analysis, 38.8% of variability in social participation was explained by medical comorbidity, psychiatric comorbidity, psychiatric symptoms, and IBD related symptoms. Conclusions The factors that predict social participation by IBD patients include income, employment, smoking, medical comorbidities, IBD symptom burden, and psychiatric comorbidities. Multivariate linear regression suggests that the most relevant factors are medical comorbidity, psychiatric comorbidity, psychiatric symptoms, and IBD symptoms. Funding Agencies CIHRCrohn’s and Colitis Canada

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Background Iron deficiency anemia (IDA) is common in persons with inflammatory bowel disease (IBD). Current evidence-based guidelines suggest iron replacement therapy in IBD patients with IDA. Intravenous (IV) iron has been demonstrated to be more effective than oral iron replacement in the IBD population, and this is thought to be related to oral iron being poorly tolerated, absorbed, and possibly having an adverse impact on the gut microbiome. Studies have not directly compared the response of IV iron between persons with ulcerative colitis (UC) and Crohn’s disease (CD). Aims (1) To compare the increase in serum hemoglobin and ferritin following IV iron therapy between persons with UC and CD. (2) To determine factors associated with response to IV iron (other than disease type), including age, sex, IBD therapies, abdominal surgeries, and IBD phenotype. Methods In a retrospective chart review, we evaluated 536 IV iron infusions (iron sucrose) prescribed to 117 IBD patients by a single gastroenterologist between 2012–2020, and collected data on IBD type, age, sex, medications (IBD therapies, NSAIDs, ASA, oral iron), abdominal surgeries, and IBD phenotype. Statistical analysis was performed using SPSS version 26. Results Most IV iron infusions were given to patients with CD (77% of infusions, 68% of persons). The majority of infusions were given as a series of multiple iron infusions (84%) over a mean of 27 weeks, rather than a single infusion. Persons with UC had a greater increase in serum ferritin than those with CD (mean difference ± SE of 13.2 ± 5.6 µg/L, p = 0.02). There was no significant difference in the increase in serum hemoglobin between UC and CD (UC= 6.5 ± 1.0 g/L; CD 4.9 ± 2.1 g/L; p = 0.62). Conclusions Persons with UC had a better ferritin response to IV iron therapy than persons with CD. Patients with UC were prescribed less IV iron than those with CD. In summary, persons with CD may require greater dosing of IV iron therapy than patients with UC. Further studies are needed to discern if this difference is secondary to CD being associated with a greater extent of mucosal disease burden, impaired iron absorption, or a greater intolerance to oral iron. Funding Agencies Fellowship Funding from Pfizer Canada

We report a case of a 71-year-old male with severe depression treated with electroconvulsive therapy (ECT) in the operating room complicated by monomorphic ventricular tachycardia (MMVT). The clinical presentation, treatment, and outcomes of this catecholamine-mediated cardiac event are reported with a brief review of the literature.