Clinico-Epidemiological Characteristics of Patients With Inflammatory Bowel Disease in Egypt: A Nationwide Multicenter Study

Abstract

Background and AimsUlcerative colitis (UC) and Crohn's disease (CD) are the most common types of Inflammatory bowel disease (IBD), with variable responses to traditional therapies and unpredicted prognosis. In Egypt and most developing countries, the lack of recent epidemiological and prognostic data adversely affects management strategies. We collected and analyzed data of patients with IBD from multiple centers across Egypt to evaluate patients' clinical and epidemiological characteristics.MethodsThis retrospective multicenter study included patients diagnosed with IBD between May 2018 and August 2021, at 14 tertiary gastroenterology units across Egypt. Record analysis addressed a combination of clinico-epidemiological characteristics, biochemical tests, stool markers, endoscopic features, histological information, and different lines for IBD treatment.ResultsWe identified 1104 patients with an established diagnosis of IBD; 81% of them had UC, and 19% showed CD. The mean age of onset was 35.1 ± 12.5 years ranging from 5 to 88 years, the mean duration of illness at inclusion was 13.6 ± 16.7 years, gender distribution was almost equal with a significant male dominance (60.4%, p = 0.003) among patients with CD, 57% were living in rural areas, and 70.5% were from Delta and Coastal areas. Two hundred nineteen patients (19.8%) displayed comorbid conditions, primarily associated with CD. The most frequent complaints were diarrhea (73.2%), rectal bleeding (54.6%) that was significantly higher among patients with UC (64%, p < 0.001), and 46.8% with abdominal pain (more often with CD: 71%, p < 0.001). Conventional therapy was effective in treating 94.7% of patients. The main lesion in patients with CD was ileal (47.8%); patients with UC mainly exhibited proctosigmoiditis (28.4%). Dysplasia was detected in 7.2% of patients, mainly subjects with UC.ConclusionsTo our knowledge, our effort is the first and largest cohort of Egyptian patients with IBD to describe clinical and epidemiological characteristics, and diagnostic and management approaches. More extensive prospective studies are still needed to fully characterize disease distribution, environmental factors, and pathological features of the disease.

Role of Intestinal Fatty Acid Binding Protein in Treated Inflammatory Bowel Diseases Patients

“…As regard disease extent, 78.3% of the IBD patients were left sided colitis. This agrees with the study which reported that the predominance of left sided colitis in 75.6% of the UC group (12) . Intestinal Fatty Acid Binding Protein (I-FABP) is considered one of the factors associated with etiopathogenesis of IBD as it can be released into the circulation as soon as the cell membrane integrity is compromised (14) .…”

Can Noninvasive Tests Substitute Endoscopy for Diagnosis of Colonic Diseases?

“…They concluded that apart from bleeding and diarrhea colonoscopic examination is unlikely to discover serious colonic disease in patients with GIT symptoms. These results support ours, as diarrhea was the main symptom (80%) of our IBD patients with nearby prevalence previously reported [22,23]. Also, 70% of our IBS patients were presented with abdominal pain and similar prevalence was previously reported [24,25].…”

Effect of Health Maintenance Program Related to Ulcerative Colitis on Selected Patient’s Outcomes during Remission Phase

“…In Egypt, the incidence of ulcerative colitis has grown during the past ten years (Lynch and Hsu, 2022). Patients with UC displayed a higher prevalence (59.2%) in Egypt and further, 70.5% were from North of Egypt (Elbadry et al, 2022). Previous studies of health maintenance programs were conducted on ulcerative colitis for reducing signs and symptoms through medication adherence without focusing on life style modification so, staying up-todate with life-long health care maintenance of patients with ulcerative colitis is critical especially in remission phase.…”

“…An early and accurate diagnosis, thorough evaluation of the patient's risk factors for negative outcomes, and then the commencement of effective, safe, and tolerable drugs is all necessary for the management of UC. Reaching a sustained steroid-free remission with appropriate normal health-related quality of life (QoL), preventing morbidity, such as frequent hospitalization and colectomy, and preventing colon cancer are the ideal therapeutic goals (Eltaweel and Elbadry, 2021). Inducing and keeping remission from UC is the major goal of treatment, with the long-term objectives of avoiding disability, colectomy, and colon cancer as secondary objectives.…”