CLINICAL AND ENDOSCOPIC CORRELATION OF

INFLAMMATORY BOWEL DISEASE

Coordinator:

Prof. Univ. Dr. Simona Băţagă

Students:

Andra Oltean

Stoica Ioan Adrian

University of Medicine and Pharmacy of Tîrgu MureşThe Faculty of Medicine

Inflammatory bowel diseases (IBD) are idiopathic, chronic diseases of gastrointestinal tract of unknown etiology. The two major types of inflammatory bowel disease are Ulcerative Colitis (UC) and Crohn disease (CD).

IBD

Crohn Disease Ulcerative Colitis

Both ulcerative colitis and Crohn’s disease are long-term (chronic) diseases that involve inflammation of the gastrointestinal tract.

Ulcerative colitis only affects the colon (large intestine) and the rectum, while Crohn disease can affect the entire digestive system, from the mouth to the anus, although a majority of the cases start in the terminal ileum.

Although Crohn disease and Ulcerative Colitis are very different diseases, both may present any of the following symptoms:

abdominal pain, vomiting, diarrhea, rectal bleeding, severe internal cramps/muscle spasms in the region of the pelvis and weight loss.

The purpose of the paper is to follow the evolution of patients with inflammatory bowel diseases, to improve symptoms and to monitor possible gastrointestinal complications.

Material and method: The retrospective study was conducted on patients

investigated by Endoscopy Laboratory of Emergency County Hospital of Târgu Mureş, Romania, for a period of two years:

January 1st 2012 – 31 December 2013.

Total number of patients(1st January 2012- 31 December 2013):

2761

Crohn Disease:19 (16, 52%)

Ulcerative Colitis:96 (83, 47%)

Patients with IBD:115 (4,16%)

Gender distribution of IBD revealed a female distribution of CD: 68,42 % and a male distribution of UC: 58,34%.

Crohn Disease

68,42%31,58%

Male Female

Ulcerative Colitis

58,35%41,66%

Male Female

The distribution of cases by age group shows a distinct affection between the two pathologies. In Crohn‘s disease are largely affected the patients aged 20-40 years, while in ulcerative colitis patients prevail aged 41-60 years.

42,10%

29,16% 36,85%

44,79%

21,05%26,05%

0,00%

10,00%

20,00%

30,00%

40,00%

50,00%

20-40 years 41-60 years 61-80 years

Distribution of cases by age

Crohn Disease

UlcerativeColitis

78,94%57,29%

0,00%10,00%20,00%30,00%40,00%50,00%60,00%70,00%80,00%

Crohn Disease UlcerativeColitis

Distribution by Area of Origin

Urban Area

Rural Area

IBD Urban Area Rural Area

Crohn Disease 78,94% 21,06%

Ulcerative Colitis 57,29% 32,71%

ComplicationsExtraintestinal complications occur in approximately 20-25%

of patients with IBD. In some cases, they may be more symptomatic than the bowel disease itself. 

Extraintestinal Complications

25%

10%

50%20%

13%18%

Scleritis

Uveitis

Erithema nodosus

Anemia

Sacroiliitis

Anxiety

IBD can be associated with several gastrointestinal complications, including risk of hemorrhage, perforation, strictures, and fistulas.

Colonoscopic image of a large ulcer and inflammation of the descending colon in a 12-year-old boy with Crohn disease.

Severe colitis noted during colonoscopy in a patient with inflammatory bowel disease. The mucosa is grossly denuded, with active bleeding noted. The patient had her colon resected very shortly after this view was obtained.

Conclusions:

Time-trend analyses showed statistically significant increases in the incidence of IBD over time, especially at young age. Years ago, the incidence of UC was several times higher than that of CD. Crohn's disease incidence in our days is approaching UC with an evolution aggravated by multiple complications.