Changing phenotype of IBD in Sri Lanka

Abstract

INTRODUCTION: Inflammatory bowel disease (IBD) is increasing in Asia Pacific, with recent changes in phenotype reported from some countries. METHOD: Patients with histologically proven IBD [ulcerative colitis(UC), Crohn’s disease(CD), unclassified(U)], diagnosed between January 2006-December 2010 (Group 1) and January 2011-December 2015 (Group 2), who had regular follow up, were included from Colombo North Teaching Hospital and National Hospital of Sri Lanka (two main referral centers). The two groups were compared with regard to phenotype of IBD (subgroups, severity, age at diagnosis, duration of symptoms, extra-intestinal manifestations (EIM) at diagnosis, cigarette smoking, family history, and highest therapy during follow up). RESULTS: 304 patients were included [Group 1: UC-72(74.2%), CD-25(25.8%); Group 2: UC-113(54.6%), CD-90(43.5%), U-4(1.9%)]. There were more females in Group 2 for UC and CD. Median age at diagnosis was similar for UC but higher for CD in Group 2 compared to Group 1.The median duration of symptoms to diagnosis was not different for UC and CD in the two groups. In both groups, left sided colitis (E2) predominated for UC and Ileo-colonic disease (L3) and non-stricturing, non-penetrating (B1) disease predominated for CD. There was no difference in degree of severity, rate of complications, pattern of EIM, smoking history at presentation, family history or highest therapy during follow up for either disease in the two groups (Table 1). CONCLUSIONS: During the 10 years, there seems to be a recent increase in the proportion of CD among IBD patients. However, there were no major changes in disease phenotype for UC or CD.