PDF | https://doi.org/10.46613/congastro2023-197
This work is licensed under CC BY 4.0
Gallegos A1, Vallejo V1, Puga M2, Marriott D3, Davila D1, Vera E1, Jara M1, Vega C1, Alcivar M1, Castells J4, Carvajal J5, Cartagena M6, Oleas R7, Buchelli P4, Arevalo M3, Marriott E3
1Hospital Teodoro Maldonado Carbo (HTMC), Guayaquil, Ecuador
2Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador
3Universidad de Especialidades Espirtu Santo (UEES), Guayaquil, Ecuador
4Universidad Católica de Santiago de Guayaquil (UCSG), Guayaquil, Ecuador
5Universidad Santiago de Chile, Santiago, Chile
6Hospital El Carmen, Santiago, Chile
7John H. Stroger, Jr. Hospital of Cook County, Chicago, Estados Unidos (EEUU)
BACKGROUND: The epidemiology of inflammatory bowel disease (IBD) goes through emergence, incidence acceleration, compounding prevalence, to prevalence equilibrium. Latin America is between the second and third stages. Epidemiological reports in this region are scarce and contradictory regarding the ratio between ulcerative colitis (UC) vs. Crohn’s disease (CD), severity at onset, or disease distribution.
AIM: To better describe IBD demography, clinical onset, management and outcomes at a tertiary hospital database.
METHODS: Observational study consisted of a consecutive registry of IBD patients ≥15 years (2007 – 2022).
RESULTS: 87 patients: 38 (43.7%) women, 64 (73.6%) UC and 23 (26.4%) CD; 2.8 UC/CD ratio. Age at diagnosis was <16 in 5 (5.7%), 16-40 in 45 (51.7%) and 40 in 37 (42.5%). Six came from Paediatrics (6.9%). Severity at debut was mild in 13 (14.9%), moderate in 52 (59.8%) and severe in 22 (25.3%). The median delay to diagnosis was 12 months. CU was proctocolitis in 14/64 (21.8%), left-sided colitis in 17/64 (26.5%), and pancolitis in 33/64 (51.5%). CD were ileal in 6/23 (26%), colonic in 6/23 and ileocolonic in 11/23 (47.8%); 3/23 were colonic and extra-ileocolonic (L1+L4). CD behaviour was inflammatory in 8/23 (34.7%), stricturing in 7/23 (30.4%) and penetrating in 8/23. There were rheumatologic manifestations in 6 IBD patients (6.9%). Surgery was required in 20 (23%). Biologics were necessary in 48 (55.2%): 40/48 infliximab, 11/48 adalimumab and 1/48 vedolizumab. To date, 63 are in remission (72.4%): 37/63 asymptomatic and 26/63 without endoscopic activity. Along with treatment, 16/87 became steroid-dependent (18.4%). The median follow-up was 3 years.
CONCLUSIONS: In comparison with other Latin American locations, a lower UC/CD ratio has been observed, with higher pancolitis (UC) and ileocolonic localisation (CD). Biologics plays a key role in treatment. Keeping updated registries is substantial to improve the IBD quality of healthcare.