Clinical differentiation of inflammatory bowel disease (IBD) in Latin America and the Caribbean.

ABSTRACT: The aim of the present study was to describe the epidemiological and clinical characteristics of inflammatory bowel disease (IBD), including medical and surgical treatments, in several countries in Latin America and the Caribbean.IBD is recognized as a global health problem because its incidence and prevalence have increased significantly over the last few years.This multicenter retrospective cohort study included 4714 patients with IBD diagnosed from 9 countries in Latin America and the Caribbean: Colombia, Cuba, Dominican Republic, Ecuador, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela.Crohn disease (CD) was more frequent in Puerto Rico (71.9%), the Dominican Republic (61.0%), and Peru (53.1%). Ulcerative colitis was more frequent in Colombia (78.6%), Venezuela (78.2%), Mexico (75.5%), Cuba (69.9%), Ecuador (64.1%), and Uruguay (60.9%). The following clinical characteristics were more frequent in the Caribbean: penetrating behavior in CD, steroid dependence, steroid resistance, intolerance to thiopurines, extraintestinal manifestations, surgeries, hospitalizations due to IBD, and family history of IBD. The factors associated with the use of biological therapy were pancolitis in ulcerative colitis, penetrating behavior in CD, steroid resistance and dependence, presence of extraintestinal manifestations, and the need for surgery.This study from Latin America and the Caribbean demonstrated the different epidemiological and clinical characteristics of IBD.

P015 Impact of IBD on Daily Lives: A Descriptive Insight to Patient's Experience in the Work and Study Settings.

BACKGROUND: Persons with inflammatory bowel diseases (IBD) endure the uncomfortable symptomatology of the disease, while trying to carry out daily activities. Given that IBD is not physically distinctive, it may be overlooked and lead to discrimination in the workplace and school. We aim to describe work and study experiences from patients with IBD. METHODS: A questionnaire containing sociodemographic, psychological, and medical inquiries was administered to patients with IBD in a tertiary care clinic. The survey captured past and present employment and scholarly status. Productivity was established by the number of early leaves or absences patients experienced due to disease symptomatology. Qualitative and quantitative data were analyzed using descriptive statistics. The study is approved by the UPR-MSC IRB. RESULTS: A total of 120 patients, 59 males and 61 females, with a mean age of 27.00 ± 9.71 were recruited. 91 participants had CD, while 29 had UC. 94% of subjects had some form of income. At the time of interview, 83 patients were working. 19% did not tell the employer of their IBD, while 19% felt discriminated at work due to their condition. 38% said the disease has limited their work goals. Of those working, 74 had to leave early or absent themselves due to disease manifestation. In the last year, 39% of patients had absented themselves for 1-2 days, 27% for 3-4 days, 9% for 5-6 days, 4% for 7-8 days, 3% for 9-10 days and 18% for more than 10 days. The mean of absences from work was 4.4 days. Patients with UC were significantly more prone to work absences than patients with CD (P = 0.0243). 69 patients were studying while having the condition. 67% achieved a college or higher degree, while 33% had high school or less. 34% had to drop a course during their school years. Of the 23 patients who experienced withdrawals, 74% had a total withdrawal from school, while 26% had a partial withdrawal at some point. 14% did not inform of their IBD at school, 12% felt discriminated because of their condition and 32% said the disease has limited their educational goals. 87% of those studying had to miss or leave school early due to disease manifestation. In the last year, 24% of patients had absented themselves for 1-2 days, 29% for 3-4 days, 7% for 5-6 days, 7% for 7-8 days, 3% for 9-10 days and 30% for more than 10 days. The mean of absences was 5.6 days. School absences were not significantly different between subjects with CD and UC (P = 0.384). 22% of participants deemed themselves as a person with a disability given their condition, while 8% did not know whether they should consider themselves as such. Perception of disability was not significantly different between patients with CD and UC (P = 0.870). CONCLUSION: Absenteeism is a significant factor affecting productivity in patients with IBD. Perception of disability may also impact work and study experiences. Raising awareness is essential for patient support in these settings.