Antalya Bölgesinde İnflamatuvar Bağırsak Hastalığının Epidemiyolojik ve Klinik Özellikleri

Year 2020, Volume: 6 Issue: 1, 32 - 41, 01.01.2020

Utku Iltar Haydar Adanır Mete Akın Dinç Dinçer

Abstract

Amaç: Ülkemizde inflamatuvar bağırsak hastalığı İBH ile ilgili epidemiyolojik ve klinik veriler yetersizdir. Özellikle bölgemizle ilgili Batı Akdeniz yayınlanmış veriye rastlanmamıştır. Çalışmanın amacı Antalya bölgesinde İBH tanılı hastaların klinik, epidemiyolojik ve demografik özelliklerinin değerlendirilmesidir.Gereç ve Yöntemler: İBH tanılı toplam 136 hasta retrospektif olarak değerlendirildi. Her hasta için hasta dosyaları, hastane verileri kullanılarak tamamlanan anketler oluşturuldu.Bulgular: Çalışma sürecinde 100 ülseratif kolit ÜK %73,5 ve 36 Crohn hastalığı CH %26,5 tespit edildi. Hastaların tanı yaşları CH için 20-30 yaşlar arasında ve 50-60 yaşları arasında olmak üzere 2 pikli karakteristik dağılım gösterdi. Kadın erkek oranı CH için 1 ve ÜK için 1,4 idi. İBH nedeniyle ameliyat olan hasta sayısı CH için 14 %38,8 olup daha sıktı. Şikâyet başlangıcı ile tanı arasında geçen ortalama medyan süre CH için 12 ay ve ÜK için 2 ay olarak saptandı. Komplikasyonlar açısından değerlendirildiğinde, en sık gözlenen bağırsak dışı komplikasyon hem CH hem de ÜK için akut artropatiydi. Sonuç: Çalışma sonuçlarının büyük bölümü daha önceki çalışma sonuçları ve literatür verileri ile uyumluydu. ÜK ve CH için hasta oranları bölgesel farklılıklar gösterdi. ÜK özellikle Doğu Anadolu kökenli hastalarda anlamlı yüksekti. Kadın/erkek oranı ÜK’de daha yüksekti. Yanlış tanı oranı CH için daha yüksekti. Semptom başlangıcı ile tanı arası geçen süre CH için belirgin yüksekti

Keywords

İnflamatuvar bağırsak hastalığı, Ülseratif kolit, Crohn hastalığı

Epidemiological and Clinical Characteristics of Inflammatory Bowel Disease in the Antalya Region

Abstract

Objective: Epidemiological and clinical data on inflammatory bowel disease IBD are insufficient in our country. There are no published data, especially from the Western Mediterranean Region. The purpose of this study was the evaluation of the clinical, epidemiological and demographical characteristics of patients with IBD in the Antalya region.Material and Methods: A total of 136 patients with a diagnosis of IBD were evaluated retrospectively. Questionnaires were completed for each patient using data from the patient files and hospital records.Results: During the study period, 100 ulcerative colitis UC 75.5% and 36 Crohn's disease CD 26.5% patients were identified. The age of the patients with CD showed the characteristic biphasic distribution with 2 peaks between 20 and 30 and then 50 and 60 years. The female/male ratio was 1/1 in CD and 1.4/1 in UC. Surgical interventions due to disease were more common in CD 38.8% . The mean lag time between the onset of complaints and confirmation of diagnosis was 12 and 2 months for CD and UC, respectively. As for complications, the most common extra intestinal complication was found to be acute arthropathy. Conclusion: The majority of our results were consistent with previous study results and literature data. The rates of patients with UC and CD showed regional differences. UC was significantly higher in patients with an Eastern Anatolia origin. The female/male ratio was higher in UC. There was a higher prevalence of misdiagnosis for CD. The mean time between the onset of symptoms and the time of diagnosis was significantly higher for CD

Keywords

Inflammatory bowel disease, Ulcerative colitis, Crohnʼs disease

References

• Hanauer SB. Inflammatory bowel disease: Epidemiology, pathogenesis, and therapeutic opportunities. Inflamm Bowel Dis 2006;12(1):3-9.
• Bennis M, Tiret E. Surgical management of ulcerative colitis. Langenbecks Arch Surg 2012;397(1):11-7. Epub 2011 Sep 16.
• Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastroenterology 2004;126:1504-17.
• Tozun N, Atug O, Imeryuz N. Clinical characteristics of inflammatory bowel disease in Turkey: A multicenter epidemiologic survey. J Clin Gastroenterol 2009;43(1): 51-7.
• Özin Y, Kilic MZ, Nadir I. Clinical features of ulcerative colitis and Crohn’s disease in Turkey. J Gastrointestin Liver Dis 2009;18(2):157-62.
• Basar Ö, Ertugrul İ, İbis M. İnflamatuvar bağırsak hastalıklarında ortalama trombosit hacmi ölçümünün hastalık aktivitesi ile ilişkisi. Türkiye Yüksek İhtisas Hastanesi Gastroenteroloji Kliniği, Ankara. Yeni Tıp Dergisi 2000;2:46-9.
• Balakan O, Kıdır V. Dicle Üniversitesi Tıp Fakültesi Hastanesinde 1999-2005 yılları arasındaki inflamatuvar bağırsak hastalıklı olgularının değerlendirilmesi. Düzce Üniversitesi Tıp Fakültesi Dergisi 2007;3:26-30.
• Shivananda S, Lennard-Jones J, Logan R. Incidence of inflammatory bowel disease across Europe: Is there a difference between North and South? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD). Gut 1996;39:690-7.
• Tragnone A, Corrao G. Incidence of inflammatory bowel disease in Italy: A nationwide population-based study. Gruppo Italiano per lo Studio del Colon e del Retto (GISC). Int J Epidemiol 1996;25(5):1044-52.
• Zhu Q, Cao Q. Quality of care for patients with inflammatory bowel disease in East China. World J Gastroenterol 2008;14(4):612-6.
• Vahedi H, Merat S. Epidemiologic characteristics of 500 patients with inflammatory bowel disease in Iran studied from 2004 through 2007. Arch Iran Med 2009;12(5):454- 60.
• Ulker A, Parlak E, Dağlı U. Epidemiology of ınfl ammatory bowel disease. Turk J Gastroenterol 1999;10: 55-9.
• Tezel A, Dökmeci G, Eskiocak M, Umit H, Soylu AR. Epidemiological features of ulcerative colitis in Trakya, Turkey. J Int Med Res 2003; 31(2): 141-8.
• Hilmi I, Singh R, Ganesananthan S, Yatim I, Radzi M, Chua AB, et al. Demography and clinical course of ulcerative colitis in a multiracial Asian population: A nationwide study from Malaysia J Dig Dis 2009;10(1):15- 20.
• Park SH, Kim YM, Yang SK, Kim SH, Byeon JS, Myung SJ, et al. Clinical features and natural history of ulcerative colitis in Korea. Inflamm Bowel Dis 2007;13(3):278-83.
• Edwards CN, Griffith SG, Hennis AJ, Hambleton IR. Inflammatory bowel disease: incidence, prevalence, and disease characteristics in Barbados, West Indies. Inflamm Bowel Dis 2008;14(10):1419-24.
• Carbonnel F, Jantchou P. Environmental risk factors in Crohn’s disease and ulcerative colitis: An update. Gastroenterol Clin Biol 2009; 33 Suppl 3:145-57.
• Firouzi F, Bahari A. Appendectomy, tonsillectomy, and risk of inflammatory bowel disease: A case control study in Iran. Int J Colorectal Dis 2006;21(2):155-9. Epub 2005 Jun 4
• Schröder O, Mickisch O. Intravenous iron sucrose versus oral iron supplementation for the treatment of iron deficiency anemia in patients with inflammatory bowel disease a randomized, controlled, open-label, multicenter study. Am J Gastroenterol 2005;100(11):2503-9.
• Thompson NP, Montgomery SM, Pounder RE, Wakefield AJ. Is measles vaccination a risk factor for inflammatory bowel disease? Lancet 1995;345:1071-4.
• Wakefield AJ, Ekbom A, Dhillon AP. Crohn’s disease: pathogenesis and persistent measles virus infection. Gastroenterology 1995;108:911-6.
• Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Paramyxovirus infections in childhood and subsequent inflammatory bowel disease. Gastroenterology 1999;116: 796-803.
• Wakefield AJ, Pittilo RM, Sim R, Cosby SL, Stephenson JR, Dhillon AP, Pounder RE. Evidence of persistent measles virus infection in Crohn’s disease. J Med Virol 1993;39(4):345-53.
• Haga Y1, Funakoshi O, Kuroe K, Kanazawa K, Nakajima H, Saito H, Murata Y, Munakata A, Yoshida Y. Absence of measles viral genomic sequence in intestinal tissues from Crohn’s disease by nested polymerase chain reaction. Gut 1996;38(2):211-5.
• Rutgeerts P, D'Haens G, Hiele M, Geboes K, Vantrappen G. Appendectomy protects against ulcerative colitis. Gastroenterology 1994;106(5):1251-3.
• Andersson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med 2001;344:808-14.
• López-Serrano P, Pérez-Calle JL, Pérez-Fernández MT, Fernández-Font JM, Boixeda de Miguel D, Fernández-Rodríguez CM. Environmental risk factors in inflammatory bowel diseases. Investigating the hygiene hypothesis: A Spanish case- control study. Scand J Gastroenterol 2010;45:1464-71.
• Frisch M, Johansen C. Appendectomy and subsequent risk of inflammatory bowel diseases. Surgery 2001;130(1): 36-43.
• Minocha A, Raczkowski CA. Role of appendectomy and tonsillectomy in pathogenesis of ulcerative colitis. Dig Dis Sci 42(7): 1567-9.
• Smithson JE, Radford-Smith G, Jewell GP. Appendectomy and tonsillectomy in patients with inflammatory bowel disease. J Clin Gastroenterol 1995;21:283-6.
• Erzin Y, Telaku S. Prevalence of appendectomy and tonsillectomy in patients with inflammatory bowel disease: a case-control study. Turk J Gastroenterol 2008; 19(3): 199-200.
• Vind I, Riis L. Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003-2005: A population-based study from the Danish Crohn colitis database. Am J Gastroenterol 2006; 101: 1274-82.
• Lapidus A, Bångstad M. The prevalence of gallstone disease in a defined cohort of patients with Crohn’s disease. Am J Gastroenterol 1999;94:1261-6.
• Parente F, Pastore L. Incidence and risk factors for gallstones in patients with inflammatory bowel disease: A large case-control study. Hepatology 2007;45:1267-74.
• Tragnone A, Hanau C, Bazzocchi G, Lanfranchi GA. Epidemiological characteristics of inflammatory bowel disease in Bologna, Italy –incidence and risk factors. Digestion 1993;54:183-8.
• Bernstein CN, Kraut A, Blanchard JF, Rawsthorne P, Yu N, Walld R. The relationship between inflammatory bowel disease and socioeconomic variables. Am J Gastroenterol 2001;96:2117-25.
• Pimentel M, Chang M, Chow EJ. Identification of a prodromal period in Crohn’s disease but not ulcerative colitis. Am J Gastroenterol 2000;95:3458-62.
• Garrido A, Martínez MJ. Epidemiology of chronic inflammatory bowel disease in the Northern area of Huelva. Rev Esp Enferm Dıg (Madrid) 2004;96(10):687- 94.
• Lakatos L, Kiss LS. Incidence, disease phenotype at diagnosis, and early disease course in inflammatory bowel diseases in Western Hungary, 2002-2006. Inflamm Bowel Dis 2011;17(12):2558-65. Epub 2011 Jan 6.
• Orchard TR, Wordsworth BP. Peripheral arthropathies in inflammatory bowel disease: Their articular distribution and natural history. Gut 1998;42:387-91.
• Turkcapar N, Toruner M. The prevalence of extraintestinal manifestations and HLA association in patients with inflammatory bowel disease. Rheumatol Int 2006;26: 663-8.
• Purrmann J, Zeidler H. HLA antigens in ankylosing spondylitis associated with Crohn’s disease. Increased frequency of the HLA phenotype B27, B44. J Rheumatol 1988;15:1658-61.
• de Vlam K, Mielants H, Cuvelier C. Spondyloarthropathy is underestimated in inflammatory bowel disease: prevalence and HLA association. J Rheumatol 2000;27:2860-5.
• Palm O, Moum B, Ongre A, Gran JT. Prevalence of ankylosing spondylitis and other spondyloarthropathies among patients with inflammatory bowel disease: A population study (the IBSEN study). J Rheumatol 2002;29(3):511-5.