Clinical Profile and Colonoscopic Findings in Patients with Ulcerative Colitis at a Tertiary Care Hospital in Nepal: a Cross Sectional Study

Bhattarai, Subash; Acharya, Ramesh Raj

doi:10.3126/jaim.v9i2.32819

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…In Nepal, UC is more prevalent than CD. Few single-center studies have looked into the clinical characteristics of patients with IBD in Nepal [8][9][10][11]. We aim to collect data from various centers throughout the country to assess the rate of identification of IBD by colonoscopy per year and to describe the gender and age distribution of IBD in Nepal.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Inflammatory Bowel Diseases in Nepal

Paudel¹,

Khanal²,

Shrestha³

et al. 2021

Cureus

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IntroductionInflammatory bowel diseases (IBD) comprise ulcerative colitis (UC) and Crohn's disease (CD). These are diseases of the gastrointestinal tract without a clear etiology but have strong relationships with underlying factors like genetic susceptibility, environmental factors, and intestinal bacteria. In the east, inflammatory bowel diseases predominantly affect the younger population and have an almost equal gender distribution. With urbanization and the adoption of the western lifestyle, the incidence and prevalence of IBD are increasing in Asia. In this study, we describe the epidemiology of IBD in Nepal. MethodsThis was an observational study conducted in nine endoscopy centers within Nepal. Two years of data of colonoscopies in these centers were collected retrospectively. IBD was diagnosed by endoscopic examination. The incidence of IBD was calculated as the number of patients with IBD per 1000 colonoscopies per year. The demographic profiles of the patients were also collected. ResultsA total of 7526 colonoscopies were done in nine centers within the two years study period. IBD was seen in 479 patients (6.3%). The incidence of UC was 23.7 per 1000 colonoscopies per year and the incidence of CD was 1.6 per 1000 colonoscopies per year. UC (87%) was more common than CD (13%). Both UC and CD were mostly seen in the 30 to 40 years age group. In patients with UC, the rectum was the most commonly affected site. DiscussionIBD in Nepal affects young males in their thirties. Younger age of affliction with a chronic disease and lack of awareness regarding the symptoms and diagnostic modalities of IBD may result in a delayed diagnosis. The target population must be made aware of the presenting symptoms of IBD and a need for colonoscopic examination for diagnosis. There is also a need for creating a national IBD registry for Nepal.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Inflammatory Bowel Diseases in Nepal

Paudel¹,

Khanal²,

Shrestha³

et al. 2021

Cureus

View full text Add to dashboard Cite

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Study of Inflammatory Bowel Disease in Patients Undergoing Colonoscopy at a Tertiary Center of Nepal

Bhattarai,

Khanal,

Shrestha

et al. 2024

Cureus

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Introduction Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract that includes ulcerative colitis (UC) and Crohn’s disease (CD). The incidence and prevalence of disease are on a rising trend. Increased case detection is related to better health awareness and improved availability of diagnostic services in the community. This article aims to calculate the incidence of IBD per 1,000 colonoscopies per year and to study the clinical and demographic characteristics of patients with IBD. Methodology It was a prospective observational study done at the National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal, from March 2023 to February 2024. All the patients who underwent colonoscopy during the study period were assessed for possible diagnosis of IBD. The Incidence rate was calculated as new IBD cases per 1,000 colonoscopies per year. Demographic and clinical profiles of the patients were collected. Results Among 1,248 patients who underwent colonoscopy during the study period, IBD was detected in 52 patients (4.16%). UC was diagnosed in 43 patients and the incidence rate of it was calculated to be 34.4 cases per 1,000 colonoscopies per year. Similarly, CD was diagnosed in nine patients with its incidence rate being 7.2 cases per 1,000 colonoscopies per year. Disease was predominantly seen in females (F:M ratio - 1.36:1). The mean age at diagnosis of IBD was 39.67 ± 14.53 years, with patients with CD being slightly younger than those with UC. The majority of patients with UC had pancolitis. The median time to diagnosis from symptom onset was three years (range: 6 months to 7 years) for CD and 10 months for patients with UC (range: 2 months to 5 years). The most common extra-intestinal manifestations were arthralgia (11, 21.15%) and arthritis (7, 13.46%). Traditional drugs like mesalamine, prednisolone, and azathioprine were commonly prescribed. Biologics were used only in two (3.84%) patients, including infliximab and adalimumab. Janus kinase inhibitor (tofacitinib) was used in three (5.76%) patients in cases of acute severe UC. Conclusions Due to the rising trend of awareness in health and availability of colonoscopy services in our country like Nepal, the incidence of IBD is seen to be quite high. UC was seen more commonly than CD, and females were predominantly involved. The majority of patients belonged to the young and middle-aged population. The majority of patients with UC had extensive colitis, while patients with CD had ileo-colonic disease with non-stricturing, non-penetrating phenotypes. Arthralgia and arthritis were the most common extra-intestinal manifestations. Conventional drugs like mesalamine, prednisolone, and immunomodulators such as azathioprine were mostly used. The use of biologics was fairly low. This study certainly contributes to the existing literature from Nepal regarding IBD.

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Clinical Profile and Colonoscopic Findings in Patients with Ulcerative Colitis at a Tertiary Care Hospital in Nepal: a Cross Sectional Study

Cited by 2 publications

References 12 publications

Epidemiology of Inflammatory Bowel Diseases in Nepal

Epidemiology of Inflammatory Bowel Diseases in Nepal

Study of Inflammatory Bowel Disease in Patients Undergoing Colonoscopy at a Tertiary Center of Nepal

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