S835 Description of Clinical Presentations of Inflammatory Bowel Disease (IBD) in Individuals Who Identify as LGBTQIA+

Abstract

Introduction: While the demographics and clinical manifestations of Inflammatory Bowel Disease (IBD) have been widely described in the general population, little is known about the clinical presentation of patients belonging to the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) community. The aim of this study was to describe the clinical presentation of IBD in individuals who identify as LGBTQIA+ at their first presentation to an IBD clinic at a tertiary referral center. Methods: This is a retrospective chart review study where patients that identify as LGBTQIA+ and that have IBD were identified using an electronic data retrieval system at a tertiary referral center. We collected information regarding their sexual orientation, gender identity (SOGI), gastrointestinal (GI) symptoms, location of disease, extent of GI tract involvement and their IBD medications at the time of their first visit to the IBD clinic. We used descriptive statistics to analyze the data. Results: The demographics, SOGI, IBD diagnosis and medications of the 93 patients included in our study are described in Table. The median time (interquartile range) from symptom onset to diagnosis and to presentation to IBD clinic were 1.4 (0; 12.7) and 72.1 (10.3; 160.5) months respectively. The extent and location of bowel involvement at the initial visit are displayed in Figure. On presentation, 46% of patients reported abdominal pain, 45% diarrhea, 25% hematochezia, 16% weight loss and 15% fatigue. Ten percent of patients had a history of clostridium difficile colitis. There were 24 patients that had more than one IBD-related emergency department visit and 17 patients that had more than one hospitalization at a tertiary referral center within one year of presentation to IBD clinic. A history of mood or anxiety disorders was assessed in 41 patients (44%), 16 of which had a history of anxiety and 19 of depression. Indications of suicidality were only assessed in 10 patients (11%). Conclusion: While this study is the first to help clarify the GI manifestations and disease characteristics of IBD in patients who identify as LGBTQIA+, further studies are needed to deepen our understanding of the epidemiology and clinical presentations of IBD in this population in comparison to a non-LGBTQIA+ cohort. This will facilitate the identification of potential healthcare disparities and barriers to timely access of patients who identify as LGBTQIA+ with IBD to clinical care.Figure 1.: Gastrointestinal involvement in patients who identify as LGBTQIA+ and who have ulcerative colitis (A, n=25) and Crohn’s disease (B, n=45; C, n=32). Table 1. - Demographics, sexual orientation, gender identity, IBD diagnosis and IBD medications of 93 individuals who identify as LGBTQIA+ All patients (n=93) Age, in years, mean (SD) 30 (15) Sex assigned at birth, Female, N(%) 59 (63) Sexual orientation, N(%) Bisexual 48 (52) Gay/lesbian/homosexual 39 (42) Other 5 (5) Prefer not to disclose 1(1) Gender Identity, N(%) Female 52 (56) Male 30 (32) Genderqueer 2 (2) Transgender female 2 (2) Other 7 (8) Race, N(%) White 85 (92) Black 3 (3) American indian/Alaska native 1 (1) Asian 1 (1) Native Hawaiian/Pacific Native Islander 1 (1) Other 2 (2) IBD diagnosis, N(%) Ulcerative colitis 48 (52) Crohn's Disease 45 (48) IBD medications at initial visit, (n=37) Mesalamine 20 (54) Corticosteroids 15 (41) Thiopurines 10 (27) Infliximab 8 (21) Adalimumab 7 (19) Vedolizumab 2 (5) Ustekinumab 2 (5) Certolizomab 2 (5) Methotrexate 1 (3) IBD: Inflammatory Bowel Disease; Data shown: Number (percentage), unless stated otherwise.