Inflammatory bowel disease (IBB) in a tertiary referral centre in Sri Lanka

Abstract

AIMS: To study disease patterns of IBD in a tertiary referral centre in Sri Lanka, METHODS: We analysed the database of outpatients with IBD maintained since 1995, reviewing records with regard to history, clinical findings, colonoscopy, histology, medical treatment, surgery, and outcome. RESULTS: Records of 108 patients with IBD were analysed [Male: Female = 68:40, mean age 38.3 years (SD 17.5), 96.5% Sinhalese]. 78 (72.2%) had ulcerative colitis (UC), 23 (20.3%) Crohn's disease (CD) and 7 (6.5%) had indeterminate colitis. The main clinical features for UC were bloody diarrhoea (95 %), tenesmus (84%), and left sided abdominal pain (74%), and for CD were watery diarrhoea (59%), tenesmus (53%) and right sided abdominal pain (47%). The main extra-intestinal manifestations were: polyarthritis - UC (18%), CD (12%), and iritis - UC (4%), CD (6%). Among UC patients 44.8% had multiple relapses and 43.5% had moderate to severe disease; in CD cases 43.5% had multiple relapses and 56.5% had moderate to severe disease, A family history was recorded in 3% of UC cases and 6% of CD. There were no intestinal complications among UC patients. Two with CD developed strictures. Proctocolectomy was performed in 13 (16.6%) patients with UC (12 had ileal pouch procedures). Five patients with CD underwent surgery; 2 right hemicolectomy, 2 fistulectomy, and 1 colectomy with ileo-rectal anastomosis. CONCLUSION: The pattern of IBD among our patients was comparable to what is described in the western literature, with the exceptions of a low frequency of family history, extra-intestinal manifestations and intestinal complications.