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Influence of urban/rural and coastal/inland environment on the phenotype and clinical course of inflammatory bowel disease patients from Sri Lanka: a cross-sectional study

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dc.contributor.author Niriella, M.A.
dc.contributor.author Kodisinghe, S.K.
dc.contributor.author Dinamithra, N.P.
dc.contributor.author Rajapakshe, N.
dc.contributor.author Nanayakkara, S.D.
dc.contributor.author Luke, H.P.D.P.
dc.contributor.author Silva, K.T.M.
dc.contributor.author de Silva, A.P.
dc.contributor.author Navarathne, N.M.M.
dc.contributor.author de Silva, H.J.
dc.date.accessioned 2017-10-20T09:51:08Z
dc.date.available 2017-10-20T09:51:08Z
dc.date.issued 2017
dc.identifier.citation Sri Lanka Medical Association, 130th Anniversary International Medical Congress. 2017;62(Supplement 1):82 en_US
dc.identifier.issn 0009-0895
dc.identifier.uri http://repository.kln.ac.lk/handle/123456789/17848
dc.description Oral Presentation Abstract (OP 049), 130th Anniversary International Medical Congress, Sri Lanka Medical Association, 13th-16th July 2017 Colombo, Sri Lanka en_US
dc.description.abstract INTRODUCTION & OBJECTIVES: Rural/urban and coastal/inland environmental influences on inflammatory bowel disease (IBD) is poorly studied. We investigated such environmental influences on IBD. METHODS: Patients with histologically proven IBD [ulcerative colitis (UC), Crohn disease (CD)] with a permanent residence and regular follow up, were included. Urban areas (UA) were defined as those administered by Municipal and Urban councils. Coastal areas (CA) were defined as areas with elevation <30 meters above sea level. Patients in different groups were compared with regard to phenotype of IBD [sex, age at diagnosis, Montreal subgroups, severity, extraintestinal manifestation (EIM) at diagnosis, and highest therapy during follow-up]. Fisher’s exact test was used to compare categorical variables. RESULTS: A total of 387 patients were included [UC-251 (64.8%), males-122 (48.6%), median followup (IQR)-22.5 (2-59) months; CD-136 (35.2%), males-65 (47.8%), median follow-up (IQR)- 63.0 (23-115) months; urban/rural distribution: UC-1.7:1, CD-1.5:1; coastal/inland distribution: both UC and CD-0.7:1]. Urban/rural or coastal/inland location did not affect the distribution of type of IBD, gender, age at diagnosis or presence of EIM. UC patients from rural areas had extensive disease (E3) (42.4% vs 24.5%, p=0.029) and used long term immunomodulator drugs more frequently (60.2% vs 47.3%; P=0.006) than UA patients. CD patients living in CA had more frequent ileo-colonic disease (L3) compared to inland patients (53.2% vs 38.0%, p=0.016). Patients with both UC and CD from inland areas needed immunomodulators or anti-TNF more frequently than coastal patients (56.7% vs 44.9%, p=0.026 and 82.1% vs 69.9%, p=0.023). CONCLUSION: IBD was more common among patients from inland, UA. Urban/rural or coastal/inland location did not affect gender, age at diagnosis or presence of EIM. However, UC patients from rural areas and CD patients from inland areas had more severe disease. en_US
dc.publisher Sri Lanka Medical Association en_US
dc.subject inflammatory bowel disease en_US
dc.title Influence of urban/rural and coastal/inland environment on the phenotype and clinical course of inflammatory bowel disease patients from Sri Lanka: a cross-sectional study en_US
dc.type Article en_US


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