The Prevalence Of Extraintestinal Manifestations In IBD

Objective: The aim of this retrospective study was to determine the characteristics and prevalence of the major extraintestinal manifestations of inflammatory bowel disease(IBD)and their relation to disease,in order to have a better understanding to manage IBD and EIMs of IBD.Methods: IBD patients seen at Gastroenterology department between January 2015 and January 2016 were retrospectively evaluated.93 IBD patients(59 M,34 F)were studied: 68 ulcerative colitis(73.1%)and 25 Crohn's disease(26.9%).The age of presentation varied from 20 to 75 years.We established the diagnosis on the basis of customary clinical criteria,endoscopic and histological scenarios.In each patient we evaluated and analyzed the data relating to sex,age at diagnosis,smoking habit,clinical history,and presence of EIMs.Results: Out of 93,EIMs were found in 19(20.4%)patients;13 UC(19.1%)and 6 CD(24%)patients.Among these 19 patients,multiple EIMs were seen in 10 patients,3 EIMs maximum whereas 9 of them had single EIMs.As compared to UC patients CD patients were slightly more inclined to have immune-mediated complications and manifestations(arthropathies,ocular,mucocutaneous,and hepatobiliary)19.1% vs 24%(P<0.05).Among all these manifestations arthritis was most frequently seen in IBD patients with a prevalence of 15.1% but arthritis has relatively same prevalence among CD and UC patients 16% and 14.7% respectively(P>0.05).Mucocutaneous manifestations were the second most common EIMs with prevalence of 8.6%,slightly more common in CD as compared to UC 12% and 7.35% respectively.Aphthous stomatitis and erythema nodosum were common EIM types of mucocutaneous manifestations in IBD patients;aphthous stomatitis: 5.38% and erythema nodosum: 3.22%.Other prominent EIMs observed in IBD patients are as follows;hepatobiliary manifestations: 4.3%,ocular and endocrinological manifestations have the same values,2.2% each.Patients with UC proctitis had decreased risk of immune-mediated EIMs,13.33%(2/15)compared to those with left-sided colitis 17.14%(6/34)and pan-colitis 26.32%(5/19)(p = 0.006).Conclusions: Overall IBD patients are not highly prone to suffered with EIMs as only 1/5 of IBD patients experienced EIMs.CD patients as compared to UC patients are slightly more susceptible to have extraintestinal manifestations.Among all these EIMs the complications of the musculoskeletal system were the mostly observed ones.Arthritis was most frequently seen in IBD patients and it affected CD and UC patients equally.Whereas more extensive distribution of inflammation in UC increases the risk of EIM.