P0464 exploring the Relationship Between Gender, Age at Onset, and the Presence and Severity of Ano-Perineal Lesions in Inflammatory Bowel Disease

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Abstract Background Ano-perineal lesions (APLs), including fissures, abscesses, fistulae, and thrombosed hemorrhoids, are common complications in inflammatory bowel disease (IBD). While several factors have been linked to the development of APLs, the impact of gender and age at disease onset on the prevalence and severity of these lesions remains underexplored. This study investigates the relationship between gender, age at IBD onset, and the presence and severity of APLs. Methods A retrospective cohort study was conducted on IBD patients to assess the relationship between gender, age at disease onset, and the presence and severity of ano-perineal lesions. The severity of APLs was categorized as mild (isolated lesions) or severe (complex fistulae, extensive abscesses). Age at onset was classified as early (<30 years) or late (>30 years). Statistical analysis, including chi-squared tests and multivariate logistic regression, was used to determine the correlation between these variables. Results • Gender differences: Male patients were more likely to present with fistulae (45%) and abscesses (34%) compared to females (fistulae: 32%, abscesses: 22%). Women, however, were more likely to have thrombosed hemorrhoids (25% vs. 15% in males). • Age at onset: Patients with early onset of IBD (<30 years) had a significantly higher likelihood of developing severe APLs (OR: 2.8, p < 0.01). Early onset was also associated with a higher prevalence of fistulae and abscesses (40% and 35%, respectively) compared to those with late-onset disease (30% and 20%). • Severity correlation: Early-onset IBD patients had more complex ano-perineal lesions, with severe fistulae and abscesses noted in 55% of cases. In contrast, late-onset patients had a significantly lower severity (25% of cases were severe). Gender further influenced severity, with males more likely to develop severe APLs (fistulae and abscesses) than females, particularly among early-onset cases. • Multivariate analysis: Gender (p = 0.02) and early age at onset (p = 0.01) were independently associated with a higher likelihood of severe APLs, with males showing a higher risk of complex lesions. Conclusion Both gender and age at onset are significant predictors of the presence and severity of ano-perineal lesions in IBD patients. Early-onset disease and male gender are associated with more severe and complex APLs, especially fistulae and abscesses. These findings emphasize the importance of early diagnosis and gender-specific management strategies for patients at higher risk of developing severe ano-perineal complications in IBD.