open access publication

Article, 2024

Inflammatory bowel disease evolution in the past two decades: a chronological multinational study

EClinicalMedicine, ISSN 2589-5370, Volume 70, Page 102542, 10.1016/j.eclinm.2024.102542

Contributors

Alavinejad, Pezhman 0000-0001-6857-6151 (Corresponding author) [1] Hashemi, Seyed Jalal 0000-0002-7389-4717 [1] Behl, Nitin Shanker 0000-0003-3998-0037 [2] Hormati, Ahmad [3] [4] Elbasuny, Abubakr 0000-0002-3213-6944 [5] Daryani, Naser Ebrahimi [4] Modarres, Mehdi Pezeshgi 0000-0001-6828-7800 [6] Arshadzadeh, Masoud [4] Panahande, Samira [1] Hang, Dao Viet [7] Mahros, Aya Mohammed 0000-0002-6849-4065 [8] Parsi, Abazar [1] Javaherizadeh, Hazhir 0000-0001-7898-4589 [1] Rehman, Ata [9] Pawlak, Katarzyna Monika 0000-0002-0771-1177 [10] [11] Ahmadi, Mitra [1] Ahmed, Mohammed Hussien 0000-0003-1761-3527 [8] Farsi, Farnaz 0000-0002-7958-5608 [12] Arefi, Mohammad [4] Quadri, Afreen [13] Tran, Quang Trung 0000-0001-8347-1614 [14] Alborzi, Foroogh [4] Alavi, Seyed Mohammad Amin 0000-0001-7885-6691 [1] Cheraghian, Bahman [1] Ramezani, Elmira [12] Gouda, Mohammed Fathi [15] [16] Saadati, Babak [17] Quadri, Ahmed Alam [18] Hirani, Rahim 0000-0002-9304-9916 [19] Maher, Maha [5] Ghoneem, Elsayed Awad [5] [16]

Affiliations

  1. [1] Ahvaz Jundishapur University of Medical Sciences
    2. [NORA names: Iran; Asia, Middle East];
  2. [2] Institute of Gastro and Liver Diseases, Fortis Hospital, Ludhiana, India
    3. [NORA names: India; Asia, South];
  3. [3] Shariati Hospital
    4. [NORA names: Iran; Asia, Middle East];
  4. [4] Tehran University of Medical Sciences
    5. [NORA names: Iran; Asia, Middle East];
  5. [5] Mansoura University
    6. [NORA names: Egypt; Africa];

Abstract

Background: The multifactorial nature of inflammatory bowel disease (IBD), which manifests differently in individuals creates a need for a better understanding of the behaviour and pattern of the disease due to environmental factors. The current study aimed to study the changes in IBD behaviour, presentation, and characteristics in patients over the past two decades with a goal of improving patients' diagnosis, management and outcomes. Methods: During a 6-month period (1/02/2022-30/07/2022), the information of patients with IBD who attended IBD outpatient clinics of 11 referral centre's in six countries was collected, and based on the first time of diagnosis with IBD, they were allocated as group A (those who were diagnosed more than 15 years ago), group B (those who were diagnosed with IBD between 5 and 15 years ago) and group C (IBD cases who diagnosed in recent 5 years). Then the most prevalent subtypes and characters of the disease are evaluated and compared to make clear if the presenting pattern and behaviour of the disease has changed in the last 2 decades. Findings: Overall 1430 patients with IBD including 1207 patients with ulcerative colitis (UC) (84.5%) and 205 patients with Crohn's disease (CD; 14.3%) included. Mean age of participants at the first time of diagnosis with IBD was 30 years. The extra-intestinal involvement of IBD in groups A and B was more prevalent in comparison with group C. Most of those in groups A & B had academic education but in group C, the most prevalent educational status was high school or diploma (P = 0.012). In contrast to groups A and B, the relative prevalence of medium socioeconomic level in group C had decreased (65%). Relative prevalence of UC subtypes was similar among groups A and B (extensive colitis as most prevalent) but in group C, the most prevalent subtype is left side colitis (38.17%). The most prevalent subtype of CD in groups A and B was ileocolic involvement while in group C, upper GI involvement is significantly increased. The rate of food sensitivity among groups A and B was more than group C (P = 0.00001). The relative prevalence of patients with no flare has increased with a steady slope (P < 0.00001). Relative prevalence of presenting symptoms among patients with UC in group C differs and nowadays the rate abdominal pain (70.7%) and bloating (43.9%) have increased and frequency of diarrhoea (67.4%) has decreased. Interpretation: In the recent 5 years, the pattern of UC presentation has changed. The rate of upper GI involvement in CD and relative prevalence of patients with no disease flare increased and the rate of extra intestinal involvement decreased. Funding: None.

Keywords

Cd, Crohn, Crohn's disease, GI involvement, IBD behaviour, IBD evolution, UC subtypes, UCS presentations, abdominal pain, academic education, age, age of participants, behavior, bowel disease, centre, changes, characteristics, characters, clinic, colitis, comparison, countries, decades, diagnosis, diarrhea, diploma, disease, disease evolution, education, educational status, environmental factors, evolution, extra-intestinal involvement, factors, flares, food sensitization, frequency, frequency of diarrhea, goal, group, group A, group B, group C, group C., high school, ileocolic involvement, individuals, inflammatory bowel disease, information, information of patients, intestinal involvement, involvement, left sided colitis, levels, management, medium socioeconomic level, multifactorial nature, multinational study, nature, no flare, outcomes, outpatient clinic, pain, participants, patient diagnosis, patients, patterns, period, presentation, presentation patterns, prevalence, prevalence of patients, prevalence of presenting symptoms, prevalent subtype, rate, referral, referral centre, relative prevalence, school, sensitivity, slope, socioeconomic level, status, steady slope, study, subtypes, subtypes of CD, symptoms, ulcerative colitis, upper GI involvement, years

Data Provider: Digital Science

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