Abstract
ABSTRACTObjectives:To determine the extent of ulcerative colitis and associated factors in patients who underwent sigmoidoscopy at Liver Center, Jail Road, Lahore, Pakistan.Methods:In this retrospective cohort study, patients who underwent sigmoidoscopy from July 2013 to July 2020 at Liver Clinic, Jail Road, Lahore, were categorized into two cohorts: who had ulcerative colitis confirmed on histology and who had no ulcerative colitis. Extent and severity of the disease as well as coexisting pathologies were also noted. SPSS version 25 was used. Independent sample T-test was applied to compare quantitative variables like age and weight, and chi-square test to compare qualitative variables with two cohorts. The p-value less than 0.05 was opted as significant. Odd ratio with 95% confidence interval (CI) were also computed for each association.Results:About 11.55% patients (165 out of 1428) had ulcerative colitis, whose mean age and mean weight were 38.27 ± 14.15 years and 74.08 ± 13.20 Kg respectively. Among ulcerative colitis patients, 18.2% had proctitis, 22.4% had proctosigmoiditis, 27.7% had left-sided colitis, and 31.5% had extensive colitis. May endoscopic severity score was found 0,1,2, and 3 in 12.1%, 23.6%, 31.5%, and 32.7% patients respectively. Ulcerative colitis cohort had significant association with younger age (p<0.01), female gender (p<0.01), non or former smoking (p=0.02) and presentation with bloody diarrhea (p<0.01), and no association with body weight (p=0.311), presence of diabetes mellitus (p=0.311) and family history of IBD (P=0.368).Conclusion:Endoscopic extent and severity of ulcerative colitis is high in our studied population. Ulcerative colitis is more prevalent in younger age and female gender patients who presented with bloody diarrhea, while the presence of active smoking has negative association with finding the ulcerative colitis. However, presence of family history of IBD, diabetes mellitus and body weight of the patient has no statistical correlation with finding ulcerative colitis during sigmoidoscopic examination in our patients.
Highlights
Ulcerative colitis is one type of inflammatory bowel disease that primarily involve mucosa of rectum and colon.[1]
All the sigmoidoscopic examinations in our setup were performed till mid-transverse colon, and the disease limited to the rectum was named as ulcerative proctitis while colitis limited to both rectum and sigmoid colon was labelled as proctosigmoiditis
Among 18.2% patients (n=30), extent of colitis was limited to the rectum only and among 22.4% patients (n=37), colitis involved both rectum and sigmoid colon
Summary
Ulcerative colitis is one type of inflammatory bowel disease that primarily involve mucosa of rectum and colon.[1] It is idiopathic immune mediated disorder with relapsing and remitting pattern.[2] It mainly presents with blood in diarrheal stool.[3] Its incidence is one to two per 100,000 people per year while its prevalence ranges from 0.24 to 7.5 per 100,000 persons in Asian region.[4] No epidemiological data is available from Pakistan. The disease has multiple complications, where toxic megacolon[5] is a life-threatening one. Truelove and Witt’s criteria;[6] tells that how much disease is severe
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