P043 IBD in Lebanon: An Observational Descriptive Sstudy.

Abstract

BACKGROUND: Inflammatory Bowel Disease (IBD), a chronic condition of industrialized societies, is imposing an increasing global health burden. While epidemiological studies are subject to variation between geographical locations, they have shown that the highest occurrences of IBD are traditionally in industrialized countries. In recent years, the incidence of disease has plateaued in those countries, but has been steadily climbing in non-industrialized areas. Lebanon is not an exception: it has seen an increase in the number of IBD patients, but no detailed studies on trends and patient characteristics have been published in the last ten years. The aim of the study was to describe the demographics of patients with Crohn's disease (CD) and ulcerative colitis (UC) in a large Lebanese hospital-based sample between the years 2012 and 2017. METHODS: The electronic medical records of patients with an employment-based health insurance who had a colonoscopy at a large academic medical center in Beirut between 2012 and 2017 were reviewed. Those patients diagnosed with UC or CD based on a combination of endoscopic, histologic and clinical history were analyzed in this study. RESULTS: During the selected period, 2055 patients underwent a colonoscopy. Among those, 63 patients were identified as having IBD of whom 32 (50.87%) were newly diagnosed cases of IBD. Of the 63 IBD patients, 29 (46%) had CD and 34 (54%) UC. The average age of patients with IBD was 35.6 ± 16.3 years with no significant difference between UC and CD patients. Most patients were male (60.3%). This male predominance was mainly present among patients with CD (21, 72.4%) compared to 17 (50%) males in the UC group. Of the 32 new cases of IBD, 17 (51.5%) had CD and 16 (48.5%) UC. The average age of newly diagnosed IBD patients was 36.4 ± 15.7 years. There was no statistically significant difference between the age at diagnosis in the CD group (37.4 ± 15.2 years) and the UC group (35.4 ± 16.7 years). The most common presenting symptom was bloody diarrhea (14, 42.4%) followed by abdominal discomfort/pain (10,30.3%) and then non-bloody diarrhea (5,15.2%). Most CD patients presented with abdominal discomfort/pain (8, 47.1%) while most UC patients presented with bloody stools (9, 69.2%). Average CRP was 25.5 ± 7.5mg/dL which was higher in CD patients (34.8mg/dL) compared to UC patients (8.8mg/dL). Similarly, average ESR was 22.9 ± 17.2 mm/hr, and it was higher in CD patients (28.8mm/hr) compared to UC patients (14.4mm/hr). Only 2 patients had a family history of IBD (6.9%). Only 3 patients (9.7%) had perianal disease and 6 (19.4%) had extraintestinal manifestations (all of whom had arthritis). CONCLUSION: The epidemiological trends and clinical characteristics of Lebanese patients with IBD are similar to Western populations. The next steps are to follow-up on incidence studies and determine if they mirror worldwide trends.