bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1132 Fecal incontinence in Inflammatory Bowel Disease (IBD): associated factors and impact on the quality of life of patients in an IBD clinic in Switzerland
Authors: Hammond P , Marques Santos J D M S , Alhassan J , Matter C , Seibold F 
Published: January 2024

Abstract

Background
Literature on prevalence of fecal incontinence (FI) in inflammatory bowel disease (IBD) and associated factors has not been thoroughly studied. IBD is a chronic disease with high morbidity and significant impact on quality of life. Awareness of prevalence and associated factors of FI would make gastroenterologists more conscious of its burden, leading to targeted clinical assessment and treatment.

Methods
We conducted a cross-sectional study, looking at risk factors for FI and its impact on quality of life. The study population consisted of IBD patients aged from 16 to 80 years old in an IBD clinic in Switzerland. Patients with a stoma, a J-Pouch and an unspecified IBD were excluded. The survey had 53 questions, with demographics and main clinical variables. The quality of life of patients was assessed using the World Health Organization quality of life scale. Disease severity was measured based on the short Crohn’s disease activity index (SCDAI) for Crohn’s disease (CD) and using the simple clinical colitis activity index (SCCAI) for Ulcerative colitis (UC). Logistic regression was used to calculate crude and adjusted odds ratio (OR), applying 95% confidence intervals (CI).

Results
450 questionnaires were randomly distributed. 392 patients met the inclusion criteria. 116 patients (29.5%) reported FI. Factors associated with FI included: age &gt; 50 years old [OR 2.74 (CI: 1.57-3.89)]; one or more vaginal delivery [OR 2.49 (CI: 1.32-4.71)];disease duration &gt; 15 years [OR 2.04 (CI: 1.31-3.16)], abdominal pain [OR 2.56 (CI: 1.60-4.09)], diarrhea [OR 3.70 (CI: 2.26-6.04)], blood in stool [OR 3.33 (1.88-5.89)], more than 3 bowel movements/day [OR 4.50 (CI: 2.79-7.26)],night bowel movements [OR 3.98 (CI: 2.36-6.71)] and an SCCAI ≥ 3 [OR 6.06 (CI: 2.62-14.02)]. There was also a positive association between the presence of one or more extraintestinal manifestation (EIM) [OR 1.64 (CI: 1.03-2.61)] and FI. General well-being [OR 2.61 (CI: 1.65-4.14)] was inversely associated with FI. Similarly, depression and anxiety were associated with FI, respectively; [OR 2.43 (CI: 1.27-4.68) and OR 1.88 (CI: 1.07-3.30)]. Noticeably, 35.3% of patients with FI could not hold their stools for more than 5 minutes, and 14.7% were unable to hold their stools for more than a minute.

Conclusion
FI was highly prevalent (29.5%) in our survey. Age, vaginal delivery, disease duration &gt;15 years, abdominal pain, diarrhea, blood in stool, &gt;3 bowel movements /day, night bowel movement, SCCAI ≥ 3, ≥ 1 EIM were associated with FI. The quality of life was significantly impacted, and anxiety and depression were associated with FI. These implications highlight the need for interventions aimed at enhancing physical and mental health outcomes among individuals with IBD.
P1155 Impact of COVID19 pandemic and vaccination among IBD patients: a multinational cross sectional survey
Authors: Alavi Nejad P , Mokhtare M , Farsi F , Arshadzadeh M , Shetty S , Eslami O , Arefi M , Emara M H , Abdelsameea E , Rezaei J , Alavi S M A , Tran Q T , Salma R , Parsi A , Ahmed M H , Monged A , Quadri A , Jawad A , Rehman A U , Lee S H , Behl N S , Ghoneem E 
Published: January 2024

Abstract

Background
The aim of current study is to evaluate impact of COVID19 pandemic and vaccination against it on the course and symptoms of IBD.

Methods
During a six months’ period, all of the IBD cases who attend in outpatient clinics of nine referral centers in 6 countries include and request to fill a questionnaire about their demographic characters and pattern of IBD, any history of involvement with COVID19 and their vaccination history.

Results
overall 812 cases from 16 countries included (52.4% male) with average age of 36.8 y (range 7 – 76). 68.5% of participants diagnosed as UC and 29.5% as CD. 80% of participants have vaccinated against COVID19 (average 2.3 times, range 1 – 5). Among those who vaccinated (group A) 31.6% experienced side effects and complication without any mortality. The most common complications of vaccination include fever (24%), fatigue (20.1%) and anorexia 8.6%. The most common reasons for vaccination refusal (group B) were fear of vaccine complication (55.5%), no believe in vaccine protection (29.6%) and fear of immunocompromised condition (17.9%). In group A overall 61% of participants involved with COVID 19 (36.2% after vaccination) in comparison with 48.1% in group B (P = 0.0052). Most of the involvements in both groups were not sever and just a minority of patients admitted to hospital (10% in group A and 6.4% in group B). Following COVID involvement, 45.1% of cases suffered with GI symptoms (mostly diarrhea (72.5%) and abdominal pain (64.5%)). In group A, 37.3% of involvements have happened before vaccination.

Conclusion
Vaccination against COVID19 is safe and effective among IBD patients and following vaccination, most of complications are minor and negligible. In case of COVID involvement, it would not be serious and there is no need to hold the medications. Among IBD patients, the most common reason for vaccination refusal is fear of vaccine side effect.
P1171 The impact of biological and small molecule therapy on time to colonic resection and cancer rates in patients with Ulcerative Colitis
Authors: Visser E , Luberto A , Heuthorst L , Bislenghi G , Hompes R , Vermeire S , D'Haens G R , Bemelman W A , Buskens C J , D'Hoore A 
Published: January 2024

Abstract

Background
The expanding medical armamentarium in ulcerative colitis (UC) has contributed to increased control of inflammation. However, simultaneously, postponed colonic resection with an accumulative inflammatory burden might lead to an increased risk of CRC. Recent studies have reported conflicting results regarding the incidence of colorectal cancer (CRC) in UC patients.

Aim
To analyse the impact of advanced medical therapies (defined as biologicals and small molecules) on time to colonic resection and risk of CRC in UC patients.

Methods
Consecutive patients ≥18 years with established UC who underwent colonic resection between January 2003 and October 2022 at the Academic Medical Centre Amsterdam or the University Hospital Leuven were included. Primary outcomes were time to colonic resection and CRC rate in colonic specimens, compared between four time periods: P1 (2003-2007), P2 (2008-2012), P3 (2013-2017) and P4 (2018-2022). Secondary outcomes were the effect of advanced medical therapy on time to resection, cancer stage and risk of CRC. CRC was staged according to the AJCC TNM classification (advanced cancer defined as T3/T4, N1/2 or M1).

Results
A total of 716 patients were included. The usage of advanced medical therapies prior to surgery increased from 38.2% in P1 to 90.2% in P4 (p&lt;0.001). However, this did not result in an increased time to colonic resection (P1: 7 years (2-12) vs P2: 6 years (2-14) vs P3: 7 years (3-14) vs P4: 7 years (2-14), p=0.94). CRC was diagnosed in 72 (10.1%) patients, and this incidence did also not change over time. Time to resection was significantly longer (median 18 years, IQR 10-24) in CRC patients compared to the overall cohort. The majority of CRC patients (64.8%) were diagnosed with advanced cancer, which did not decrease over time. Patients using advanced medical therapies had significantly shorter follow-up compared to therapy-naïve patients (6 years vs. 10 years, p&lt;0.001), which resulted in a decreased risk of CRC (OR 0.17, p=&lt;0.001). However, the finding of an incidental carcinoma rate (i.e. not preoperatively diagnosed) in this group was 18% whereas this was only 4% in patients without advanced medical therapy (p=0.08). Moreover, the incidence of advanced CRC was numerically higher in UC patients who received ≥2 therapies (83.3% vs 61.0%, p=0.14).

Conclusion
This study demonstrated that in the last two decades, the increased usage of advanced medical therapies did not result in an increased time to resection, nor in a decreased CRC rate in UC patients undergoing colonic resection. A higher incidence of incidental and advanced cancers was seen in patients with ≥2 therapies. Therefore, care should be taken with improved tailored surveillance in this group.
P1172 Epidemiology and initial presentation of newly diagnosed inflammatory bowel diseases in a Danish population-based inception cohort – results from the IBD Prognosis Study
Authors: Attauabi M , Roager Madsen G , Bendtsen F , Seidelin J , Burisch J 
Published: January 2024

Abstract

Background
It is unclear whether the incidence of inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), continues to increase. In this study, we aimed to investigate the occurrence and initial disease presentation of IBD in a population-based setting. In addition, we aimed to identify predictors of an early severe disease presentation.

Methods
The study was conducted as part of IBD Prognosis Study, an ongoing Danish prospective population-based inception cohort study that includes incident patients with IBD according to the Copenhagen Diagnostic Criteria since May 2021, covering the catchment areas of approximately 20% of the Danish population (1.1 million). In this analysis, cutoff for data analysis was in May 2023. Crude incidence rates and European Standard Population (ESP)-adjusted rates were calculated. A multivariable logistical regression model was constructed to identify predictors of a severe disease presentation, defined as the composite need for systemic steroids, immunomodulators, biologics, or IBD-related surgery within three months of disease.

Results
In total, 554 patients (UC: 344, CD: 210) fulfilled the inclusion criteria, resulting in the following crude incidence rates per 100,000 person-years: IBD 23.4 (95% CI 21.5-25.4), UC 14.0 (12.6-15.6), and CD 8.6 (7.4-9.8). ESP-adjusted rates were: IBD 20.4 (18.2-22.9), UC 11.8 (10.2-13.0), and CD 7.9 (6.5-9.9) (Figure 1).
Among patients with UC, 81 (26.3%) and 95 (30.8%) had left-sided or extensive colitis at disease onset, respectively, while 61 (30.3%) and 62 (30.8%) patients with CD had ileal or ileocolonic disease. Stricturing or penetrating CD behaviour was observed in 24 (11.9%) and 11 (5.5%) patients, respectively. A high proportion of patients needed hospitalization (CD: 68 (33.8%), UC: 60 (19.5%), p=0.001) and IBD-related surgery (CD: 21 (10.4%), UC: 10 (3.2%), p=0.004) at the time of diagnosis.
In multivariable analysis, a severe disease presentation of UC at the time of diagnosis was associated with left-sided or extensive disease distribution, thrombocytosis, and increased levels of C-reactive protein (CRP) (Table 1). In patients with CD, stricturing, or perianal disease, as well as anemia, levels of albumin, CRP, and calprotectin were predictive of this endpoint (Table 1).

Conclusion
The incidence of UC and CD in Denmark appears stable compared to historical data from the previous decades.1 The study identified clinical predictors of a severe disease presentation from the time of diagnosis, emphasizing the critical need for early risk stratification and intervention strategies.
Reference:
1 Dorn-Rasmussen M et al., J Crohns Colitis. doi: 10.1093/ecco-jcc/jjac138.
P1175 Abdominal Pain is Associated with Poor Quality of Life in Quiescent Inflammatory Bowel Disease: A Cross-sectional Study of the SPARC Inflammatory Bowel Disease Cohort
Authors: Dilmaghani S , Dunleavy K , Fehlmann T , Raffals L , Chedid V 
Published: January 2024

Abstract

Background
Abdominal pain (AP) is common in patients with active inflammatory bowel disease (IBD) and has been associated with poor quality of life (QOL). Despite greater therapeutic options, symptoms persist in a subset of patients. Data is lacking regarding AP in patients with objectively documented quiescent disease. Among endoscopic quiescent disease: (1) estimate prevalence of AP, (2) assess predictors of worse AP, (3) describe its impact on validated QOL measures.

Methods
This cross-sectional study used prospectively collected data from SPARC (Study of a Prospective Adult Research Cohort) IBD, a multicenter longitudinal study of well-phenotyped adult IBD patients initiated by the Crohn’s & Colitis Foundation in 2016. Quiescent IBD was defined as Mayo endoscopy score &lt;2 for ulcerative colitis (UC) and SES-CD score &lt;3 for Crohn’s disease (CD). Patient reported outcomes (PROs) within 30 days of endoscopy were analyzed. Patients with ostomy or IPAA were excluded. Self-reported AP was categorized as none, mild, or moderate/severe. Univariate statistics used Pearson’s Chi-square and Kruskal-Wallis tests.

Results
A total of 973 patients with quiescent IBD (606 CD; 367 UC) were included in the study (Table 1). AP was more commonly reported in quiescent CD (31.2% mild, 15.5% moderate/severe) as compared to quiescent UC (23.4% mild, 10.1% moderate/severe) (p&lt;0.001). In the entire quiescent cohort, those with mild or moderate/severe AP were more likely to be female sex (63.1% mild; 67.4% moderate/severe; p&lt;0.001), higher BMI (28.4 mild; 30.0 moderate/severe; p=0.008) and have more recent tobacco use (p=0.004). Ileocolonic involvement was more commonly seen in moderate/severe AP. Mild and moderate/severe AP was associated with subjective fecal urgency, stool frequency, and bloody stool (all p&lt;0.001). Disease behavior in CD was not associated with abdominal pain.
General well-being was poorer for those with more severe AP (p&lt;0.001), though this did not appear to result in more frequent recent ED visits or hospitalizations. Figure 1 depicts the PROMIS responses. Overall, worse AP was associated with universal worse scores on all PROMIS measures and subscales (all p&lt;0.001). Data suggested that more severe AP had the greatest impacts on the "Fatigue" subscale.

Conclusion
In this study of patients in SPARC IBD with endoscopic quiescent IBD the overall prevalence of AP was 41.7% overall and more commonly reported in CD as compared to UC. AP was associated with a greater prevalence of other symptoms, worse general well-being, and poorer quality of life across all measures. Further research is needed to elucidate the pathophysiology for presence of AP in quiescent IBD and develop personalized management approaches.
P1183 Perception of the role of diet on symptom exacerbation in patients with Inflammatory Bowel Disease
Authors: Deiana S , Biancheri P , Imbesi V , Gabbani T , Zadro V , Soriani P , Gionchetti P , Manno M 
Published: January 2024

Abstract

Background
A substantial proportion of patients with inflammatory bowel disease (IBD) believe that diet plays an important role in disease activity. As a result, IBD patients often change their dietary regimen in order to improve their symptoms and to prevent recurrences, however most of them choose self-imposed dietary restrictions that may lead to malnutrition and to a significant reduction in quality of life. The aim of our study was to evaluate dietary habits and the perception of the relationship between diet and symptoms in IBD patients.

Methods
A semi-structured questionnaire assessing demographics, clinical features, perception of the role of diet on symptom exacerbations and dietary habits including adoption of food restrictions was developed by our gastroenterologists and dietitians and was administered to patients with IBD.

Results
85 patients with IBD (56 with Ulcerative Colitis and 29 with Crohn’s Disease, mean age 55.0 ± 15.9 years, 43 males) were enrolled in the study. Most IBD patients did not perceive diet as a possible cause of disease (68/85 patients, 80.0%) or relapses (70/85 patients, 82.3%), but the majority of them (55/85 patients, 64.7%) believed that certain foods and drinks could worsen disease symptoms. Alcohol, carbonate drinks, milk, spicy and fat foods were often considered as a possible cause of symptom deterioration. Although 50/85 patients (58.8%) stated that they changed their diet after the diagnosis, only 19/85 patients (22.3%) declared to adopt a "restrictive" diet by reducing or avoiding some foods. However, 64/85 patients (75.3%) showed low/intermediate adherence to Mediterranean Diet (MD) (calculated with the MediLite Score), and no patient had high adherence to MD. Finally, the majority of IBD patients declared that they would like to receive more information on diet in relation to their disease.

Conclusion
In our study, the majority of IBD patients perceived that certain foods and drinks could worsen disease symptoms and accordingly changed their diet after the diagnosis. The adoption of restrictive diets is probably more frequent than declared by IBD patients, as suggested by the high prevalence of low/intermediate adherence to MD. Education of healthcare providers is important to improve knowledge and quality of nutrition in IBD patients.
P1186 Unveiling the reality of Collagenous colitis: Beyond its Benign Façade
Authors: Kottwitz J , Mudege T , Giaslakiotis K , Hoque S S 
Published: January 2024

Abstract

Background
Microscopic colitis is a cause of chronic watery, non-bloody diarrhoea diagnosed mainly on histology after taking biopsy from essentially normal colonoscopy. Thereby mainly two subtypes can be identified: Lymphocytic and collagenous colitis. So far, no biomarkers for the diagnosis of microscopic colitis have been identified. Hower, despite being benign nature of this disease .it often trigger Two weeks wait (cancer path way) of the in the UK.

Methods
In this study, we analysed all cases of collagenous colitis diagnosed from 2018-2022 in the Northeast London from 5 different teaching hospitals. 104 cases were identified and their electronic health record from hospital and from the primary care physicians (GP) were manually reviewed.

Results
In this cohort, 24% male, 76% female with ratio of (1:3), with mean age of 65 years. Forty percent were active or ex-smoker.
Painless watery diarrhoea was the main cause for referral in 90% of cases, 7% had painless bloody diarrhoea, whilst 3% complaint painful bloody diarrhoea. Abdominal pain noted in only 39% cases. Thirty-five (35%) cases noted to have history of weight loss. Among these patients, 27% had Haemoglobin &lt; 130g/L, including 7% had &lt;105g/L. Twenty nine percent had Faecal calprotectin (FCP) &gt; 50 microgram/gm of stool and 14% had FCP &gt;200. Seventeen percent had serum inflammatory marker raised CRP (normal 0-10).
Thirteen percent (13%) of these patient trigger two weeks pathway referral as they had positive Faecal immunochemical test (FIT) which used for bowel cancer screening test,
Twenty-seven (27%) presents did not require any treatment, got better after stopping suspected medication as a cause, while 73 % require treatment, of whom 5% require treatment with immunomodulator/ Biologics.

Conclusion
In this large series of collagenous colitis, we found that, despite being benign condition, it can present with alarming features which both health care provider and patient should be aware of, in order to avoid unnecessary anxiety. Further studies are needed to identify biomarker of this condition.
P1215 Blastocystis is very rare in faeces of children with Crohn’s disease: quantity, subtyping and association with the faecal bacteriome
Authors: Hurych J , Hlináková L , Lerchová T , Kubát M , Malcová H , Cebecauerová D , Hradský O , Bronský J , Cinek O 
Published: January 2024

Abstract

Background
Blastocystis is a single-cell gut protist, presumably an indicator of gut health. We aimed to assess its occurrence and subtypes in a longitudinal set of faecal samples from recently diagnosed paediatric patients with Crohn's disease (CD) and compare it to similar longitudinal collections from children having other chronic immunopathological diseases without gut pathology (type 1 diabetes, T1D, and juvenile idiopathic arthritis, JIA), as well as to control subjects.

Methods
At a single tertiary centre, 626 samples were collected from 156 subjects: 40 with CD (mean age 12.5 years), 57 with T1D, 10 with JIA and 49 healthy. Specific real-time PCR detected and quantified Blastocytis, whereas massively parallel amplicon sequencing showed its subtype. The relationship between Blastocystis and the bacterial community was assessed by 16S rDNA amplicon profiling.

Results
Blastocystis was detected in 4.0% (9/223) stool samples in CD, six of them being of a very high quantity and originating from a single patient in long-term remission with a less common CD phenotype (L2, colonic, according to Paris classification). Subject-wise positivity of Blastocystis in CD (3/40, 7.5%) was significantly lower than in either T1D (21/57, 37%), JIA (2/10, 20%), or in healthy children (14/49, 29%). There was no notable difference in the subtype repertoires among diagnoses. The faecal bacteriome had higher alpha diversity in Blastocystis-positive samples. The Blastocystis-positive bacteriomes had slightly yet significantly (p&lt;0.001) different overall community composition across all diagnoses (Figure 1), which was also reflected by the suggestive differential abundance of several taxa (e.g. Ruminococcaceae and Prevotellaceae increased, Bacteroidaceae and Rikenellaceae decreased).

Conclusion
We performed a large molecular survey on Blastocystis in longitudinal samples of three different paediatric diagnoses and healthy subjects. We document an unusual long-term carriage of very high loads of Blastocystis in a patient with colonic CD phenotype in clinical remission. Otherwise, however, Blastocystis is very rare among paediatric patients with CD, in contrast to two other chronic immunopathologic childhood diagnoses (T1D, JIA). Further longitudinal observation will show whether Blastocystis might return in patients with well-controlled CD upon ameliorating their bacteriome composition.

Institutional Grants/Research Supports
Supported by Ministry of Education, Youth and Sports of the Czech Republic, programme INTER-EXCELLENCE II, project LUC23165.