P-047 Inflammatory Bowel Disease

The incidence and prevalence of inflammatory bowel disease (IBD) has increased. In Chile information is scarce. Our aim was to determine epidemiologic and clinical changes in patients with IBD at our institution. This is a retrospective descriptive study of a cohort of IBD patients enrolled in a registry in a private Chilean hospital, started on 2012, with patients diagnosed between 1976 and July of 2014. It includes clinical, imaging, endoscopic and pathological information of the patients. A total of 398 IBD patients (57% female) were enrolled in our registry, including 287 (72.1%) with ulcerative colitis (UC), 101 (25.3%) with Crohn’s disease (CD) and 10 with non-classifiable IBD. The median age was 35 years (range: 18–86). The UC/CD ratio was 2.8/1. Most of our patients were diagnosed between 2004 and 2014 (69.6%) with a significant increase (P <0.001) comparing to past decades (Figure 1). In both, UC and CD diagnose peaks were between age 20 and 29 years, equally distributed between genders (Figure 2). According to the Montreal classification, UC patients had proctitis (E1), left colitis (E2) and extensive colitis (E3) in 30.7%, 19.2% and 50.1%, respectively. In CD, ileal involvement (L1), colonic (L2) and ileocolonic disease (L3) were observed in 32.7%, 39.6% and 26.7% of patients. Inflammatory (B1), stricturing (B2) and penetrating (B3) behavior were reported in 82.2%, 9.9% and 6.9% of CD patients. Twenty-nine percent of CD patients had additional perianal disease and 4 patients (4%) upper GI involvement. Nine patients switched from UC to CD, and 5 CD patients changed their disease behavior, 4 from B1 to B2 and 1 from B1 to B3. In UC, 25 patients increased the extension of disease (11 from E1 to E2, 7 from E2 to E3 and 7 from E1 to E3). Thirty-five percent of UC and 50% of CD patients had extra-intestinal manifestations. Fifty-one patients have been treated with biological therapy (46 patients with infliximab, 4 adalimumab and one with natalizumab). Median time between diagnosis and the use of biological therapy was 1 year in patients diagnosed after 2007 compared to 5 years in patients diagnosed before (P < 0.001). Eight patients have developed cancer during this time; two of them colon cancer. When comparing UC and CD, there were significant differences in the age at diagnoses, medical treatment, hospitalization due to crisis and surgery due to IBD (Table 1). Epidemiology and clinical characteristics of our patients were similar to other studies. At our institution, IBD has progressively increased over the past decades. A national registry is needed to assess the epidemiological changes of IBD in Chile.

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