Saudi Arabia consensus guidance for the diagnosis and management of adults with inflammatory bowel disease

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Background: Pediatric inflammatory bowel disease (PIBD) has been documented all over the world, and there is now a large body of clinical, pathological, and treatment knowledge and protocols in place in many countries. There is currently limited knowledge on the prevalence and pathology of PIBD in Omani population. The aim of this study is to report the incidence and clinical features of PIBD in Oman. Methods: This was a retrospective, cross-sectional, multicenter study carried out on all children <13 years of age between January 1, 2010 and December 31, 2021. Results: Fifty-one children were identified, 22 males (43.1%) and 29 females (56.9%), who were mostly from the Muscat region of Oman. The median incidence in the country was 0.57 (confidence interval [CI]: 0.31–0.64) per 10 5 children for inflammatory bowel disease (IBD), 0.18 (CI: 0.07–0.38) per 10 5 children for ulcerative colitis (UC), and 0.19 (CI: 0.12–0.33) per 10 5 children for Crohn’s disease (CD). There was a significant increase in the incidence of all PIBD types after the year 2015. Bloody diarrhea was the most common symptom, followed by abdominal pain. Perianal disease affected nine children (40.9%) with CD. Conclusion: The incidence of PIBD in Oman is lower than in some neighboring Gulf countries but similar to that of Saudi Arabia. An alarming upward trend was noted from the year 2015. Large-scale population-based studies are required to investigate the possible causes of this increasing incidence.

Section: Discussionmentioning

confidence: 99%

Incidence and clinical characteristics of pediatric inflammatory bowel disease in Oman

Lawati¹,

Rawahi²,

Bahlani³

et al. 2023

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“…The incidence and prevalence of IBD continue to increase in Saudi Arabia. [ 15 ] There are currently no data on the prevalence of EBV seropositivity among patients with IBD in Saudi Arabia. This information has clinical implications as it can help identify patterns and importance of EBV screening in IBD patients planning on commencing thiopurine therapy.…”

Section: Introductionmentioning

confidence: 99%

Epstein-Barr virus seroprevalence among inflammatory bowel disease patients in Saudi Arabia

Al-Bawardy,

Alfadley,

Almousallam

et al. 2024

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Background: Seroprevalence of Epstein-Barr virus (EBV) in patients with inflammatory bowel disease (IBD) is variable based on geographic distribution. There are no published data on the seroprevalence of EBV in patients with IBD in Saudi Arabia. This study aims to assess the seroprevalence of EBV in patients with IBD in a tertiary center in Saudi Arabia. Methods: This is a retrospective chart review of patients ≥14 years of age with a confirmed diagnosis of IBD and known EBV status at our institution from January 1, 2018, to January 1, 2023. The primary outcome was the seroprevalence of EBV in IBD. Secondary outcomes included factors associated with EBV seropositivity and rates of EBV seroconversion in originally negative patients. Results: A total of 150 patients were included (74.7% with Crohn’s disease, median age 28 years [interquartile range 21-36.3]). EBV non-exposure was noted in 16.8% (n = 25). The mean age was significantly lower in the EBV-naïve group at 26 ± 8.5 years compared to the EBV-exposed group at 31.2 ± 12.9 years (P = 0.02). Seroprevalence of EBV was highest in patients >40 years of age (92.9%) and lowest in patients 14-25 years of age (78.2%). The rate of seroconversion in EBV-naïve patients was 16.7% after a mean follow-up time of 47.9 ± 46.3 months. Conclusion: In our cohort of IBD patients, 16.8% were naïve to EBV, and young age was a significant predictor of EBV non-exposure. Our data supports the practice of assessing EBV before initiating thiopurine therapy since EBV seroprevalence is not universal in our population.

“…[ 3 ] Treatment selection is typically based on many factors such as disease location, phenotype, severity, presence of extraintestinal manifestations (EIMs) of IBD, perianal involvement, risk of infection, comorbidities, and accessibility. [ 9 ] In elderly patients, the dynamics of treatment selection differ compared to the younger patient due to the increased risk of infection, presence of comorbidities, and risk of malignancies. A clear description of disease characteristics and treatment patterns in this subpopulation of IBD patients is necessary for better decision-making.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory bowel disease in the elderly: A focus on disease characteristics and treatment patterns

Mosli

Alghamdi

Bokhary

et al. 2023

Background: As the population ages, the number of elderly inflammatory bowel disease (IBD) patients is expected to increase. The clinical features and therapeutic options for young and old patients may differ, as elderly IBD patients are likely to have different comorbidities and disease characteristics. The goal of this study was to examine the clinical aspects and therapeutic choices for elderly Saudi IBD patients. Methods: We conducted a retrospective study aimed at describing the demographic, clinical, and management characteristics of IBD in elderly patients (≥60 years) who followed up at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. The data was extracted from the KAUH inflammatory bowel disease information system (IBDIS) registry. The primary outcome was to describe disease characteristics in accordance with the Montréal classification and the secondary outcomes were to describe treatment patterns and identify significant clinical associations. Results: Our data were collected from 76 patients who fulfilled the study inclusion criteria. Females outnumbered males (53.9% vs 46.1%) and the mean age was 51.5 ± 9.7 years. Essential hypertension (26.3%) was the most common comorbidity followed by diabetes mellitus (23.6%), and malignant neoplasms (9.21%). More than half of the patients with Crohn’s disease (CD) had disease onset after forty years of age. The most common form of disease distribution was ileocolonic disease (64.7%). Less than 17% of patients had a penetrating disease phenotype. About 88 percent of patients with UC presented >40 years of age. Approximately, half of the cohort had left-sided ulcerative colitis (UC) (48%), followed by pancolitis (40%). The most prescribed medication class for IBD was 5-aminosalicylic acid (5-ASA) derivatives (56.58%) followed by corticosteroids and immunosuppressive drugs. Conclusions: In Saudi Arabia, age-specific concerns including comorbidities and polypharmacy remain the major challenges in the management of elderly IBD patients.