bluuebunny/crossref_metadata_2025_split huggingface dataset:
P746 Prevalence, features and outcomes of splachnic vein thrombosis in inflammatory bowel disease. A nationwide, retrospective study from the ENEIDA registry
Authors: Masnou H , Mañosa M , Menchén L , Mesonero F , Bujanda L , Castro J , Gonzalez-Partida I , De Francisco R , García-Alonso F J , García M J , González-Muñoza C , Huguet J M , Iborra M , Cano-Sanz N , Domènech Moral E 
Published: January 2020

Abstract

Background
The risk of splanic vein thrombosis (SVT) -as defined as that involving the portal vein and/or its intrahepatic branches, mesenteric, splenic and/or suprahepatic veïns is mainly observed, among others, in inflammatory abdominal conditions. Thromboembolic complications are frequent among patients with inflammatory bowel disease (IBD). However, there is little information on the prevalence, characteristics, risk factors and evolution of SVT in patients with IBD. Our aims were to describe the characteristics of SVT in patients with IBD, diagnostic explorations, treatment and evolution.

Methods
Retrospective, multicentre, descriptive study of the ENEIDA registry with a diagnosis of SVT. In addition to epidemiological and clinical features of IBD, we recorded specifically diagnosis, treatment, disease activity at the time of SVT and outcome of SVT.

Results
Over 59,000 IBD patients in the ENEIDA registry, only 49 episodes of SVT were identified (35 Crohn’s / 14 Ulcerative Colitis); 69% men, median age 42 years old, 35% smokers. 37% had a past history of surgery and/or abdominal inflammatory conditions, 16% extra-intestinal neoplasia, 23% baseline immune or hematologic conditions and 14% liver disease. Finally, 16% had a previous episode of venous thrombosis. The most frequent forms of clinical presentation were abdominal pain with/without fever (59%), and radiological findings in the setting of active IBD (25%). ST coincided with IBD activity in 76% of cases. The diagnosis of SVT was based in the findings of an abdominal CT in 82%. The most frequent localition of SVT were intrahepatic portal branches (51%) and superior mesenteric vein (47%). Only 47% had a basic aetiological study, and 37% underwent gastroscopy (median 7 months from the diagnosis of SVT) showing oesophageal varices in 67%. Anticoagulation therapy was prescribed in 94% of the episodes (74% within the first month since diagnosis), for a median of 7 months. In 90% of the cases, there was a further radiological assessment, 61% of which showing the resolution of the SVT (median of 5 months from the beginning anticoagulation treatment).

Conclusion
SVT seems to be a rare (or underdiagnosed) complication in IBD patients, it is mostly associated with disease activity and evolves suitably when anticoagulation therapy is suitably started.
P769 Prevalence and duration of gastrointestinal symptoms in the 10 years before diagnosis of inflammatory bowel disease: A national cohort study
Authors: Blackwell J , Saxena S , Jayasooriya N , Petersen I , Hotopf M , Bottle A , Pollok R 
Published: January 2020

Abstract

Background
Gastrointestinal (GI) symptoms of Inflammatory Bowel Disease (IBD) may go undiagnosed resulting in diagnostic delay.
Aims: To determine the frequency and duration of GI symptoms in the decade before the diagnosis of Crohn’s Disease (CD) and ulcerative colitis (UC) and risk factors for delayed specialist review.

Methods
We used the Clinical Practice Research Datalink, a nationally representative research database, to identify incident cases of CD and UC diagnosed from 1998 to 2016. Comparison cohorts without IBD were matched 4:1 for age and sex and assigned the IBD diagnosis date of their matched IBD patient as a pseudo-diagnosis date. We compared the prevalence of GI symptoms between the IBD and comparison cohorts in the 10 years before IBD diagnosis. We identified individuals with chronic GI symptoms lasting more than 6 weeks and measured their time to receiving a specialist review with a gastroenterologist, paediatric gastroenterologist or colorectal surgeon. We identified risk factors for receiving specialist review after presenting with chronic GI symptoms.

Results
We identified 5874 incident cases of CD, 13,681 incident cases of UC and comparison cohorts of 78,114 individuals. 10% of the CD and UC cohorts reported GI symptoms to their primary care physician 5 years before diagnosis.

Fewer than 50% of patients were reviewed by a specialist within 18 months of presenting to their primary care physician with chronic GI symptoms. Patients with a previous diagnosis of Irritable Bowel Syndrome (IBS) or depression were less likely to receive timely specialist review (IBS: HR 0.77, 95%CI 0.60–0.99, depression: HR 0.77, 95%CI 0.60–0.98).

Conclusion
A substantial number of individuals experience GI symptoms many years before receiving a diagnosis of IBD. IBS and depression are risk factors for delayed specialist review. Rapid diagnostic pathways should be established to reduce the burden of diagnostic delay in IBD.
P770 Ascertainment of pediatric inflammatory bowel disease cases from administrative health data in Québec, Canada
Authors: Jantchou P , Conus F , Richard H , Rousseau M C 
Published: January 2020

Abstract

Background
Administrative databases are useful for estimating population-level disease occurrence. Our objective was to ascertain cases of pediatric inflammatory bowel disease (IBD) by applying two validated algorithms to administrative health data, evaluate agreement, and compare health services utilisation between concordant and discordant cases.

Methods
The Quebec Birth Cohort on Immunity Health was established through linkage of administrative databases and includes 400 611 persons born in the province of Québec (Canada) from 1970 to 1974. Physician consultations (PC) and hospitalisations (H) for IBD were documented in health databases until 2014. Two validated algorithms were used to identify pediatric IBD cases. Firstly, a single-step algorithm was applied [5PC or 2H within 4 years]. Secondly, a two-step algorithm was implemented, first considering whether the person had undergone sigmoidoscopy/colonoscopy before age 18 [yes: 4PC or 2H within 3 years; no: 7PC or 3H within 3 years]. We evaluated the agreement between both algorithms using the Kappa statistic, and compared health services utilisation among concordant and discordant cases using a t-test.

Results
The single-step algorithm generated 527 pediatric IBD cases (0.13%), whereas 480 (0.12%) were identified with the multi-step algorithm. Among the 534 cases identified by either algorithm, 473 (88.6%) were identified by both, 54 (10.1%) only by the single-step, and 7 (1.3%) only by the multi-step algorithm. Kappa was 0.94 (95% confidence interval: 0.92, 0.95), and the proportions of positive and negative agreement were respectively 0.94 and 1.00. The average number of PC and H before age 18 years among concordant and discordant cases was respectively 26.0 and 3.9 (p &lt; 0.0001).

Conclusion
The prevalence of pediatric IBD was similar when applying two different case identification algorithms, few cases were discordant. In the near future, a survey conducted in a subset of the cohort will allow us to compare self-report with ascertainment from administrative databases.
P783 Non-alcoholic fatty liver disease and advanced liver disease in patients with inflammatory bowel disease: prevalence and risk factors
Authors: Demir M 
Published: January 2020

Abstract

Background
Increased occurrence of non-alcoholic fatty liver disease NAFLD is observed in patients with IBD. The aim of this study was to assess the prevalence and risk factors of NAFLD and associated advance liver fibrosis in patients with IBD

Methods
This is a retrospective study. Between January 2010 and August 2019, patients with Crohn’s disease/ulcerative colitis who admitted to our Gastroenterology Unit were included in the study. Hepatic steatosis was assessed by abdominal ultrasound. The diagnosis of advanced fibrosis was evaluated with non-invasive FIB 4 score and FIB-4&gt;3.25 was considered an advanced liver disease. Patients with a history of excessive alcohol or recent steroid use, chronic viral hepatitis and other chronic liver diseases were excluded. Univariate and multivariate analysis were performed.

Results
Five hundred and thirty-nine, 52% male, mean age 44 ± 18 years, were enrolled. Among 539 IBD patients, 322 (59.7%) in ulcerative colitis patients vs. 217 (41.3%) in Crohn’s disease patients were diagnosed. The sonographic prevalence of NAFLD was 32% (172/539) and advanced liver disease was found in 12% (21/172) in IBD patients with NAFLD. Univariate analysis showed that &gt;40 years old (p = 0.034), ≥25 Body Mass Index (BMI)(p &lt; 0.001), presence of metabolic syndrome(p &lt; 0.001) and type 2 diabetes(p &lt; 0.001), ≥5 years of duration of disease (p &lt; 0.001), biological agents and/or azothiopurine use in the past (p &lt; 0.001), ≥126mg/dl fasting plasma glucose (p = 0.04), elevated alanine aminotransferase (ALT) (p &lt; 0.001), ≥240mg/dl total cholesterol (p = 0.021), ≥150mg/dl triglyceride (p = 0.038) and hyperuricemia (p = 0.019) were risk factors for NAFLD in patients with IBD. According to the multivariate analysis presence of metabolic syndrome and type 2 diabetes, ≥5 years of duration of disease and elevated ALT were an independent predictive factor of NAFLD (respectively, p &lt; 0.003, p = 0.002, p &lt; 0.001, p &lt; 0.001). Univariate analysis showed that &gt;40 years old (p = 0.037), the presence of metabolic syndrome (p &lt; 0.001), type 2 diabetes (p &lt; 0.001) and Crohn’s disease (p = 0.012), history of surgery (p = 0.003), ≥5 years of duration of disease (p &lt; 0.001), elevated ALT (p &lt; 0.001) and &lt;3 mg/dl albumin (p = 0.038) were risk factors for advanced liver disease in IBD patients with NAFLD. According to the multivariate analysis, the presence of type 2 diabetes and ≥5 years of duration of disease was an independent predictive factor of advanced liver disease in IBD patients with NAFLD (respectively, p &lt; 0.001, p &lt; 0.001).

Conclusion
NAFLD is a very common disease in patients with IBD. NAFLD is not rare cause of advanced liver disease in patients with IBD. Type 2 diabetes and ≥5 years of duration of disease were an independent predictive factor of advanced liver disease in IBD patients with NAFLD.
P790 Dental caries occurrence among patients with inflammatory bowel disease (IBD)
Authors: Piątek D , Jarmakiewicz-Czaja S , Korona-Głowniak I , Malm A , Sztembis J , Filip R 
Published: January 2020

Abstract

Background
Inflammatory bowel disease (IBD), including patients’ diet, way of treatment and general health may have an impact on teeth condition. Due to multifactorial nature of caries that its linked to susceptibility of hard tooth tissues, cariogenic microorganisms and presence of fermentable carbohydrates, the course of disease can be modified at many levels. The aim of the study was to assess dental caries experience in adult patients with Crohn’s disease (CD) and ulcerative colitis (UC).

Methods
The study involved 224 individuals: 98 with diagnosed CD, 75 with UC and 51 of control group (CG) with mean age 34.7. The complete assessment of the hard tooth tissues based on the DMFT index (decayed D, missing M, filled F teeth) was performed.

Results
There were no statistically significant differences between the examined groups in terms of DMFT index values, however, a statistically significant difference was found in the number of teeth with caries (D) (mean 3.99, 3.05 and 1.96 for CD, UC and CG respectively; H=13.55 p &lt; 0.05). All groups had higher mean D values in men than women, and achieved the highest mean value in CD group (4.78) compared with UC (3.68) and healthy controls (2.06)(H=8.71 p &lt; 0.05). The results of D values for CG obtained in our study confirm the literature data for healthy population aged 35–44 in Poland (mean D~2). The number of lost teeth (M) in the studied population was high and amounted to 5.47, 5.25 and 3.94 for the examined groups, respectively. A thorough analysis showed that in the group of men the difference in the M value was statistically significant at 5.83, 5.94 and 1.11 for CD, UC and CG respectively (H=15.84 p &lt; 0.05). Statistically significant differences (H=6.21 p &lt; 0.05) were observed in the number of filled teeth (F), without secondary caries, which highest value was recorded in CG (10.76) and the lowest in the CD group (8.93).

Conclusion
The highest D and M values were observed in patients with CD, especially in men, which proves the intensity and activity of dental caries disease in this group.
P794 Nutritional assessment in inflammatory bowel disease (IBD): development of the Groningen IBD Nutritional Questionnaires (GINQ)
Authors: Peters V , Alizadeh B , de Vries J , Dijkstra G , Campmans-Kuijpers M 
Published: January 2020

Abstract

Background
Diet plays a key role in the complex aetiology and treatment of inflammatory bowel disease (IBD). Most existing nutritional assessment tools neglect intakes of important foods consumed or omitted specifically by IBD patients or incorporate non-Western dietary habits, making development of appropriate dietary guidelines for (Western) IBD patients difficult. Hence, we developed a food frequency questionnaire (FFQ), the Groningen IBD Nutritional Questionnaires (GINQ-FFQ); suitable to assess dietary intake in IBD patients.

Methods
To develop the GINQ-FFQ multiple steps (Figure 1) were taken; identification of IBD specific foods, literature search and evaluation of current dietary assessment methods. Expert views were collected and in collaboration with Wageningen University, division of Human Nutrition and Health, this semi-quantitative FFQ was developed using standard methods to obtain a validate questionnaire. Next, the GINQ-FFQ was digitalised into a secure web-based environment which also embeds additional nutritional and IBD-related questions.

Results
The GINQ-FFQ is an online self-administered FFQ evaluating dietary intake over the past month as a proxy of habitual intake of the previous six months. The GINQ-FFQ consists of 121 questions on 218 food items. It takes about 45 min to fill out the GINQ-FFQ.

Conclusion
This paper describes the design process of the GINQ-FFQ which is newly developed to assess dietary intakes especially (but not exclusively) in IBD patients.
P798 Societal costs attributable to Crohn’s disease and ulcerative colitis within the first 5 years after diagnosis: –a Danish Nationwide Cost-of-Illness Study 2003–2015
Authors: ALULIS S , Vadstrup K , Borsi A , Elkjær Stallknecht S , Olsen J , Rikke Jørgensen T , Wennerström C , Qvist N , Munkholm P 
Published: January 2020

Abstract

Background
There is little information on cost-of-illness among patients diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC) in Denmark. The objective of this study was to estimate the average 5-year societal costs attributable to CD or UC including costs related to health care, prescription medicine, home care, and production loss.

Methods
Incident patients with CD or UC were identified in the National Patient Registry and matched with a non-IBD control from the general population on age and sex. Attributable costs were estimated applying a difference-in-difference approach, where the total costs among individuals in the control group were subtracted from the total costs among patients. Information on primary and secondary healthcare services were obtained from the National Health Insurance Service Registry.

Results
CD and UC incidence was approximately 14 and 31 per 100,000 persons-years, respectively. Average attributable costs were highest the first year after diagnosis, with costs equalling €12,919 per CD patient and €6,501 per UC patient. Hospital admission costs accounted for 36% in the CD population and 31% in the UC population, the first year after diagnosis. Production loss exceeded all other costs the third year after diagnosis.

Conclusion
We found that the societal costs attributable to incident CD and UC patients are substantial compared with the general population, primarily consisting of hospital admission costs and production loss. Appropriate treatment at the right time may be beneficial from a societal perspective.
P806 Increasing incidence of microscopic colitis in a population-based cohort study in a French speaking region of Switzerland
Authors: Maye H , Ekaterina S , Schoepfer A 
Published: January 2020

Abstract

Background
Microscopic colitis (MC) is a chronic inflammatory disease of the colon presenting with watery diarrhoea. It encompasses two entities, namely lymphocytic colitis (LC) and collagenous colitis (CC). Population-based epidemiologic data the frequency and natural history of microscopic colitis are scarce. We evaluated the clinical presentation at diagnosis, incidence and prevalence of MC in Cantons of Vaud and Fribourg, Switzerland.

Methods
Cantons of Vaud and Fribourg lie in the French-speaking, Western part of Switzerland. As of 12/2017, both cantons together had a population of 1,109,230 inhabitants. We contacted all Pathology institutes (n = 6) in both cantons in order to identify patients that have been diagnosed with microscopic colitis. We then performed a chart review in all adult and paediatric gastroenterology practices in order to identify MC patients and to assess the incidence, prevalence, their clinical, endoscopic, and histological characteristics as well as natural history.

Results
Out of 252 patients, a total of 218 fulfilled the diagnostic criteria for MC, whereof 123 had LC and 95 had CC. Age at first diagnosis of MC was 63.2 ± 14.3 years (62.8 ± 14.3 for LC, 63.7 ± 14.4 years) and median diagnostic delay was 1.1 ± 3.1 years. Symptoms leading to MC diagnosis were diarrhoea (100%), abdominal pain (31.7%), weight loss (31.2%), bloating (20.6%), fatigue (9.6%), and nausea/vomiting (3.2%). The following risk factors were found in MC patients: statins (27.1%), aspirine (23.4%), proton pump inhibitors (22.5%), serotonine reuptake inhibitors (22.5%), smoking (20.2%), non steroidal anti-inflammatory drugs (14.2%), and neuroleptics (4.1%). Median exposure time to risk factors was 55 months (IQR 33–78, range 1–280 months). Associated auto-immune diseases (celiac disease, type 1 diabetes, autoimmune gastritis, autoimmune thyroiditis, rheumatoid arthritis) were found in 14 patients (6.4%). No patient was diagnosed with MC prior to 1994. Incidence of MC significantly increased from 0.36/100,000 inhabitants in 1994–1997 to 6.85/100,000 inhabitants in 2017 (p = 0.025). The cumulative prevalence of MC, LC, and CC in 2017 was 19.65/100,000, 11.09/100,000, and 8.56/100,000, respectively.

Conclusion
The incidence and cumulative prevalence of MC shows a steady increase in an indicator region of roughly 1 million inhabitants in French speaking part of Switzerland.
P813 Inflammatory bowel disease in older patients: experience at a single centre
Authors: Diaz Alcazar M M , Martinez Tirado P , Vidal Vilchez B , Zuñiga de Mora Figueroa B 
Published: January 2020

Abstract

Background
The characteristics of inflammatory Bowel Disease (IBD) seem different according to the age of the patient at diagnosis. Moreover, age influences the evolution of the disease. The aim of the study was to know the prevalence of IBD in patients older than 65 years old and the evolution of the disease at this age.

Methods
Retrospective descriptive study. Database from patients of the Hospital Universitario San Cecilio of Granada (Spain). 50 patients with 65 years old or more and 50 under this age have been randomly selected. Their electronic clinical records have been reviewed.

Results
The IBD Unit in our Hospital serves 1218 people with this disease, of whom 212 are elderly patients (17.4%). In the serie of 100 randomly selected patients, mean age is 58.42 years. The disease began before 65 years old in 74% of elderly patients.
All the elderly patients continue follow-up, while 4 (8%) of the younger patients dropped out the follow-up in the IBD Unit. With regard to hospital admissions, 27 elderly patients (54%) have never required hospitalisation compared with 18 (36%) aged under 65 years. Corticosteroids were used at diagnosis in 27 (54%) of older vs. 28 (56%) of the younger patients. Meanwhile, topical treatment is used by 33 (66%) of older vs. 22 (44%) of the younger ones. The current treatment is summarised in Figure 1.

Conclusion
(1) The prevalence of IBD is increasing. IBD in older patients is also escalating due to the low mortality of the disease and the increase of patients with late-onset. In our serie, the prevalence in elderly patients is 17.4%. (2) UC is more frequent in older patients than in younger ones (70% vs. 42%). With regard to CD, penetrating disease is less frequent in older patients but stricturing pattern is more prevalent. (3) Adherence to follow-up in elderly patients is higher and they need fewer hospital admissions than younger patients. (4) In our serie, surgical and biological treatments are less frequent in elderly patients. Moreover, there are more patients above 65 years that do not take maintenance treatment or they only take mesalamine. (5) Chronological age is different from biological age. Older patients with a good quality of life should not be excluded from new treatments or clinical trials due to age. More evidence about older patients is needed to improve de diagnosis, the knowledge about the evolution and define better the treatment in this group of age.
P825 The impact of a SNP-dose–response effect on course of inflammatory bowel disease: a numerical analysis of SNP distribution within the Swiss IBD Cohort Study
Authors: Biedermann L , Denoth L , Rossel J B , Butter M , Vavricka S , Misselwitz B , Greuter T , Schreiner P , Cleynen I , Rogler G , Scharl M 
Published: January 2020

Abstract

Background
Several large genome wide association studies have identified an increasing number of IBD risk loci with currently more than 240 established loci and generated robust data on disease association. However, knowledge remains limited on distinctive associations to specific clinical characteristics. The Swiss IBD Cohort Study (SIBDCS) represents a large prospective cohort study with clinically and phenotypically sound data collection since 2006 including genotyping. In this study, we aimed to determine individual associations of known risk loci with clinical features of patients in the SIBDCS, as well as their combined effect on clinical outcomes.

Methods
Based on 158 analysed SNPs, we investigated the numerical distribution of risk alleles and determined an individual SNP risk score (defined as percentage of risk alleles; i.e. number of risk alleles divided by twice the number of given SNPs multiplied with 100). We then performed linear regression modelling to investigate, whether relevant clinical disease characteristics associate with this SNP risk score. Further, for each given clinical outcome, a model was run with all SNPs as potential predictors, and the number of significant associations per SNP counted.

Results
In a total of 2304 genotyped patients, we observed a median number of risk alleles of 167, 168 and 167 for IBD overall, CD and UC/IC, respectively with a narrow inter quartile range [11 (q25 = 162, q75 = 173) for IBD and CD; 12 (q25 = 161, q75 = 173) for UC/IC]. A higher SNP risk score was significantly associated with any complications (defined as a composite of any or more of colorectal cancer, colon dysplasia, intestinal lymphoma, osteopenia/-porosis, anaemia, deep venous thrombosis, pulmonary embolism, nephro- or cholelithiasis, malabsorption syndrome, massive haemorrhage, perforation/peritonitis, pouchitis), stenosis in CD patients; pancolitis, conversion to CD, female sex in UC patients; higher clinical disease activity in both CD & UC.
Regarding individual SNPs, we identified substantial differences in terms of the frequency of associations to disease-related outcomes with up to 11 for rs4899554 in CD and 7 for rs9557195 in UC, respectively.

Conclusion
In our large population of IBD patients there is high per patient frequency of hetero- and homozygous SNP risk alleles. The association of higher SNP risk score with several disease-related outcomes indicates a potential interplay of per patient given SNP risk alleles.