ObjectiveDetermine the variables associated with hospitalisations in patients with Crohn’s disease and those associated with surgery, intestinal resection, hospital readmission, need for multiple operations and immunobiological agent use.DesignA cross-sectional study was conducted from 2019 to 2021, using two centres for inflammatory bowel diseases in the Brazilian Public Health System.ResultsThis study included 220 patients. Only perianal disease was associated with hospitalisation (31.6% vs 13.0%, p=0.012). Stricturing or penetrating behaviour (35.8% vs 12.6%, p<0.001) and perianal disease (45.9% vs 9.9%, p<0.001) were associated with surgery. Ileal or ileocolonic location (80.0% vs 46.5%, p=0.044) and stricturing or penetrating behaviour (68.0% vs 11.2%, p<0.001) were associated with intestinal resection. Steroids use at first Crohn’s disease occurrence and postoperative complications were associated with hospital readmission and need for multiple operations, respectively. Age below 40 years at diagnosis (81.3% vs 62.0%, p=0.004), upper gastrointestinal tract involvement (21.8% vs 10.3%, p=0.040) and perianal disease (35.9% vs 16.3%, p<0.001) were associated with immunobiological agent use.ConclusionPerianal disease and stricturing or penetrating behaviour were associated with more than one significant outcome. Other variables related to Crohn’s disease progression were age below 40 years at diagnosis, an ileal or ileocolonic disease localisation, an upper gastrointestinal tract involvement, the use of steroids at the first Crohn’s disease occurrence and history of postoperative complications. These findings are similar to those in the countries with a high prevalence of Crohn’s disease.

Background and Aims Fecal incontinence is an important complaint reported by patients with Crohn’s disease and it is associated with several disease-related mechanisms, including anorectal functional disorders. This study aimed to assess the anorectal function and clinical characteristics to identify parameters associated with fecal incontinence in Crohn’s disease patients. Methods This is a cross-sectional study of 104 patients with Crohn’s disease, aged 18 years or older, from a referral center between August 2019 and May 2021. Patients responded to a specific questionnaire, and underwent medical record review, proctological examination, and anorectal functional assessment with anorectal manometry. Results Of the 104 patients, 49% were incontinent. Patients with incontinence had a lower mean resting pressure (43.5 mmHg versus 53.1 mmHg; p = 0.038), lower mean squeeze pressure (62.1 mmHg versus 94.1 mmHg; p = 0.036), and lower maximum rectal capacity (140 ml versus 180 ml; p &lt; 0.001). Fecal incontinence was also associated with disease activity (p &lt; 0.001), loose stools (p = 0.02), perianal disease (p = 0.006), previous anoperineal surgery (p = 0.048), and the number of anorectal surgeries (p = 0.036). Conclusions This is the largest reported study describing manometric findings of Crohn’s disease patients with and without fecal incontinence. Our results identified an association between FI and functional disorders, in addition to clinical features in these patients. Functional assessment with anorectal manometry may help choose the best treatment for FI in patients with CD.

Objective: Currently, variables associated with Crohn’s disease progression remain insufficiently investigated in developing countries. Thus, this study aimed to determine the variables associated with hospitalizations in patients with Crohn’s disease and those associated with surgery, intestinal resection, hospital readmission, surgical recurrence, and immunobiological agent use.Results: A retrospective cross-sectional study was conducted from 2019 to 2021, using two centers for inflammatory bowel diseases in the Brazilian Public Health System. This study included 220 patients. Perianal disease was associated with hospitalization. Stricturing or penetrating behavior and perianal disease were associated with surgery. Ileal or ileocolonic location and stricturing or penetrating behavior were associated with intestinal resection. Furthermore, steroid use at first Crohn’s disease occurrence and postoperative complications were associated with hospital readmission and surgical recurrence, respectively. Age below 40 years at diagnosis, upper gastrointestinal tract involvement, and perianal disease were associated with immunobiological agent use. These findings are similar to those in the countries with a high prevalence of Crohn’s disease, and could be applicable in other developing countries. Knowing these variables is useful in identifying the severity profile of Crohn’s disease and selecting the most appropriate management and treatment.

Background The identification of variables associated with evolution to moderate to severe disease is essential for the therapeutic management of patients with Crohn’s disease (CD). However, studies on this topic are scarce in developing countries. The main objective of this study is to determine the variables associated with hospitalization in patients with CD. The secondary objective is to identify variables associated with surgery, intestinal resection, rehospitalization, surgical recurrence and use of immunobiological therapy. Methods Cross-sectional study with a retrospective component that involved two reference centers for inflammatory bowel diseases in the public health system. Data were collected through a specific questionnaire and review of medical records in the period 2019 to 2021. The association between variables was evaluated through Chi-Square test and multivariate binary logistic regression. Results Were included 220 patients, 50.9% female. The most common findings were: age at diagnosis between 17 and 40 years (67.7%), colonic location (45.0%) and no stricturing no penetrating behavior (75.9%). Perianal disease was observed in 27.7% and involvement of the upper gastrointestinal (GI) in 16.1% (Table 1). 174 (79.1%) patients were hospitalized, 109 (49.5%) underwent surgery, being 50 (22.7%) bowel resection. 106 (60.9%) were readmitted, 13 (26.0%) presented surgical recurrence and 128 (58.2%) used immunobiologicals. Perianal disease was the only variable associated with hospitalization (p=0.012). Stricturing or penetrating behavior (p&lt;0.001) and perianal disease (p&lt;0.001) were associated with surgery. Regarding intestinal resection, ileal or ileocolon location (p=0.044) and stricturing or penetrating behavior (p&lt;0.001) were variables associated. The use of corticosteroids in the first flare (p&lt;0.001) was associated with rehospitalization, and postoperative complications (p=0.029) with surgical recurrence. Age at diagnosis below 40 years (p=0.004), upper GI involvement (p=0.040) and perianal disease (p&lt;0.001) were associated with the use of immunobiologicals (Table 2). Conclusion This is a pioneer study in Brazil on variables associated with evolution to moderate to severe CD. Perianal disease and stricturing or penetrating behavior were associated with more than one outcome. Age at diagnosis below 40 years, ileal and ileo-colic location, upper GI involvement, use of corticosteroids in the first flare and postoperative complications were also variables found. These data are similar to those found in countries with a high prevalence of the disease1. Reference 1. Torres J et al. Predicting Outcomes to Optimize Disease Management in Inflammatory Bowel Diseases. J Crohns Colitis. 2016;10(12):1385–1394.