S50 A Comparison of Perceived Severity and Clinical Presentation in Patients With Inflammatory Bowel Diseases

Abstract

Background: Inflammatory bowel diseases (IBD) can present with diverse clinical patterns. Patient perception relative to illness severity may be influenced by a variety of factors, such as IBD type, disease extension, or number of surgeries associated to the condition. Although objective clinical presentation might establish some degree of severity, patient perception towards the disease could differ. In this study, we aim to determine variance between patients’ perception of severity and patterns or extension of their corresponding disease, along with surgical history that can contribute to their viewpoint. Methods: Patients with IBD attending a tertiary care clinic and participating in a study of the impact of IBD in productivity completed an anonymous questionnaire in an interview format. We assessed the patient's perceptions regarding the severity of their conditions and medical history. The medical history section includes inquiries about the patient's number of surgeries associated with the condition and clinical patterns by IBD type, which were validated using retrospective record review. Bivariate and multivariate analyses were executed. This study is approved by the UPR-MSC IRB. Results: A total of 130 patients, 99 with CD and 31 with UC, were recruited (68F/62M, mean age: 30.18 ± 10.03). The mean age at onset of symptoms was 21.42±9.04 years, while the mean age at diagnosis was 22.32±8.98 years. When assessing patient’s perception on the severity of their condition, 58% indicated their disease to be slightly to moderately severe, 29% said it is quite to highly severe, and 13% mentioned their disease is not severe. In patients with CD, the following clinical patterns were identified: 35% with an inflammatory pattern, 14% as stenosing, and 51% as fistulizing. Additionally, 18% had perianal involvement. In terms of severity and CD clinical pattern, there was no significant difference between a perception of quite to high severity of the disease and any of the phenotypes (P = 0.3210). For patients with UC, 42% had left-sided colitis and 58% had pancolitis. There was no significant difference when comparing perception of quite to high severity and extension of UC (P = 0.3541). Of those recruited, 67 had some type of surgery to treat their condition. However, there was no significant difference between the number of patients with surgeries that perceived their condition to be quite to highly severe and those without surgeries that also perceived their condition to be quite to highly severe (P = 0.1876). Conclusion(s): The study showed that there was no single determinant among the variables examined that significantly increased patients’ perception of having severe disease. Individuals that reported a quite to high severity of their condition did not illustrate a particular pattern or extension of IBD. Further studies pertaining to patient sentiment and perception towards disease severity are of utmost importance to help improve care and treatment.