Background and Aims: A delay in the diagnosis of inflammatory bowel disease (IBD) is a risk of developing complications and surgery. This study was done to evaluate the factors and impact of diagnostic delay on IBD patients in Bangladesh. Methods: This cross-sectional study was carried out in the Department of Gastroenterology of a tertiary care center in Bangladesh. Diagnostic delay was defined as the period from symptom onset to diagnosis of IBD. Results: Of the total 112 IBD patients 50 (44.6%) had Crohn’s disease CD and 62 (55.4%) had ulcerative colitis (UC). Males (67.9%) were predominant in the study. The median diagnostic delay was longer for patients with CD compared with patients with UC (median 24 versus 12 months; P-value 0.025). Rectal bleeding as presenting feature and male gender were negatively and positively associated with the longer diagnostic delay of IBD respectively (P-value <0.05). Of the patients with CD 14 (28%) had a history of IBD-related surgery and 7 (14%) had a history of perianal fistula. The presence of intestinal strictures, surgery, and perianal fistula at the time of diagnosis was significantly associated with long diagnostic delay for CD. Conclusion: Absence of rectal bleeding as presenting symptoms and also the male gender were the significant factors related to the longer diagnostic delay of IBD in our study. Long diagnostic delay is associated with an increased rate of complications in IBD, especially in CD.
| Published in | American Journal of Internal Medicine (Volume 8, Issue 6) |
| DOI | 10.11648/j.ajim.20200806.13 |
| Page(s) | 258-262 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Diagnostic Delay, Inflammatory Bowel Disease (IBD), Crohn’s Disease (CD), Ulcerative Colitis (UC), Referral Delay
| [1] | Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018; 390 (10114): 2769-2778. |
| [2] | D'Haens G, Baert F, van Assche G, et al. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease: an open randomised trial. Lancet. 2008; 371 (9613): 660-667. |
| [3] | Schreiber S, Colombel JF, Bloomfield R, et al. Increased response and remission rates in short-duration Crohn's disease with subcutaneous certolizumab pegol: an analysis of PRECiSE 2 randomized maintenance trial data. Am J Gastroenterol. 2010; 105 (7): 1574-1582. |
| [4] | Khanna R, Bressler B, Levesque BG, et al. Early combined immunosuppression for the management of Crohn's disease (REACT): a cluster randomised controlled trial. Lancet. 2015; 386 (10006): 1825-1834. |
| [5] | Nguyen VQ, Jiang D, Hoffman SN, et al. Impact of Diagnostic Delay and Associated Factors on Clinical Outcomes in a U.S. Inflammatory Bowel Disease Cohort. Inflamm Bowel Dis. 2017; 23 (10): 1825-1831. |
| [6] | Nahon S, Lahmek P, Paupard T, et al. Diagnostic Delay Is Associated with a Greater Risk of Early Surgery in a French Cohort of Crohn's Disease Patients. Dig Dis Sci. 2016; 61 (11): 3278-3284. |
| [7] | Danese S, Fiorino G, Mary JY, et al. Development of Red Flags Index for Early Referral of Adults with Symptoms and Signs Suggestive of Crohn's Disease: An IOIBD Initiative. J Crohns Colitis. 2015; 9 (8): 601-606. |
| [8] | Burgmann T, Clara I, Graff L, et al. The Manitoba Inflammatory Bowel Disease Cohort Study: prolonged symptoms before diagnosis--how much is irritable bowel syndrome? Clin Gastroenterol Hepatol. 2006; 4 (5): 614-620. |
| [9] | Vavricka SR, Spigaglia SM, Rogler G, et al. Systematic evaluation of risk factors for diagnostic delay in inflammatory bowel disease. Inflamm Bowel Dis. 2012; 18 (3): 496-505. |
| [10] | Schoepfer AM, Dehlavi MA, Fournier N, et al. Diagnostic delay in Crohn's disease is associated with a complicated disease course and increased operation rate. Am J Gastroenterol. 2013; 108 (11): 1744-1753; quiz 1754. |
| [11] | Nahon S, Lahmek P, Lesgourgues B, et al. Diagnostic delay in a French cohort of Crohn's disease patients. J Crohns Colitis. 2014; 8 (9): 964-969. |
| [12] | Li Y, Ren J, Wang G, et al. Diagnostic delay in Crohn's disease is associated with increased rate of abdominal surgery: A retrospective study in Chinese patients. Dig Liver Dis. 2015; 47 (7): 544-548. |
| [13] | Pellino G, Sciaudone G, Selvaggi F, Riegler G. Delayed diagnosis is influenced by the clinical pattern of Crohn's disease and affects treatment outcomes and quality of life in the long term: a cross-sectional study of 361 patients in Southern Italy. Eur J Gastroenterol Hepatol. 2015; 27 (2): 175-181. |
| [14] | Moon CM, Jung SA, Kim SE, et al. Clinical Factors and Disease Course Related to Diagnostic Delay in Korean Crohn's Disease Patients: Results from the CONNECT Study. PLoS One. 2015; 10 (12): e0144390. |
| [15] | Lee DW, Koo JS, Choe JW, et al. Diagnostic delay in inflammatory bowel disease increases the risk of intestinal surgery. World J Gastroenterol. 2017; 23 (35): 6474-6481. |
| [16] | Cantoro L, Di Sabatino A, Papi C, et al. The Time Course of Diagnostic Delay in Inflammatory Bowel Disease Over the Last Sixty Years: An Italian Multicentre Study. J Crohns Colitis. 2017; 11 (8): 975-980. |
| [17] | Zaharie R, Tantau A, Zaharie F, et al. Diagnostic Delay in Romanian Patients with Inflammatory Bowel Disease: Risk Factors and Impact on the Disease Course and Need for Surgery. J Crohns Colitis. 2016; 10 (3): 306-314. |
| [18] | Gomollón F, Dignass A, Annese V, et al. 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management. J Crohns Colitis. 2017; 11 (1): 3-25. |
| [19] | Magro F, Gionchetti P, Eliakim R, et al. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders. J Crohns Colitis. 2017; 11 (6): 649-670. |
| [20] | Cosnes J, Gower-Rousseau C, Seksik P, Cortot A. Epidemiology and natural history of inflammatory bowel diseases. Gastroenterology. 2011; 140 (6): 1785-1794. |
| [21] | Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J. Behaviour of Crohn's disease according to the Vienna classification: changing pattern over the course of the disease. Gut. 2001; 49 (6): 777-782. |
| [22] | Benevento G, Avellini C, Terrosu G, Geraci M, Lodolo I, Sorrentino D. Diagnosis and assessment of Crohn's disease: the present and the future. Expert Rev Gastroenterol Hepatol. 2010; 4 (6): 757-766. |
APA Style
Chanchal Kumar Ghosh, S. M. Ali Hasan, Md Abdur Rahim Miah. (2020). Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh. American Journal of Internal Medicine, 8(6), 258-262. https://doi.org/10.11648/j.ajim.20200806.13
ACS Style
Chanchal Kumar Ghosh; S. M. Ali Hasan; Md Abdur Rahim Miah. Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh. Am. J. Intern. Med. 2020, 8(6), 258-262. doi: 10.11648/j.ajim.20200806.13
AMA Style
Chanchal Kumar Ghosh, S. M. Ali Hasan, Md Abdur Rahim Miah. Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh. Am J Intern Med. 2020;8(6):258-262. doi: 10.11648/j.ajim.20200806.13
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Download@article{10.11648/j.ajim.20200806.13,
author = {Chanchal Kumar Ghosh and S. M. Ali Hasan and Md Abdur Rahim Miah},
title = {Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh},
journal = {American Journal of Internal Medicine},
volume = {8},
number = {6},
pages = {258-262},
doi = {10.11648/j.ajim.20200806.13},
url = {https://doi.org/10.11648/j.ajim.20200806.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20200806.13},
abstract = {Background and Aims: A delay in the diagnosis of inflammatory bowel disease (IBD) is a risk of developing complications and surgery. This study was done to evaluate the factors and impact of diagnostic delay on IBD patients in Bangladesh. Methods: This cross-sectional study was carried out in the Department of Gastroenterology of a tertiary care center in Bangladesh. Diagnostic delay was defined as the period from symptom onset to diagnosis of IBD. Results: Of the total 112 IBD patients 50 (44.6%) had Crohn’s disease CD and 62 (55.4%) had ulcerative colitis (UC). Males (67.9%) were predominant in the study. The median diagnostic delay was longer for patients with CD compared with patients with UC (median 24 versus 12 months; P-value 0.025). Rectal bleeding as presenting feature and male gender were negatively and positively associated with the longer diagnostic delay of IBD respectively (P-value <0.05). Of the patients with CD 14 (28%) had a history of IBD-related surgery and 7 (14%) had a history of perianal fistula. The presence of intestinal strictures, surgery, and perianal fistula at the time of diagnosis was significantly associated with long diagnostic delay for CD. Conclusion: Absence of rectal bleeding as presenting symptoms and also the male gender were the significant factors related to the longer diagnostic delay of IBD in our study. Long diagnostic delay is associated with an increased rate of complications in IBD, especially in CD.},
year = {2020}
}
TY - JOUR T1 - Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh AU - Chanchal Kumar Ghosh AU - S. M. Ali Hasan AU - Md Abdur Rahim Miah Y1 - 2020/10/30 PY - 2020 N1 - https://doi.org/10.11648/j.ajim.20200806.13 DO - 10.11648/j.ajim.20200806.13 T2 - American Journal of Internal Medicine JF - American Journal of Internal Medicine JO - American Journal of Internal Medicine SP - 258 EP - 262 PB - Science Publishing Group SN - 2330-4324 UR - https://doi.org/10.11648/j.ajim.20200806.13 AB - Background and Aims: A delay in the diagnosis of inflammatory bowel disease (IBD) is a risk of developing complications and surgery. This study was done to evaluate the factors and impact of diagnostic delay on IBD patients in Bangladesh. Methods: This cross-sectional study was carried out in the Department of Gastroenterology of a tertiary care center in Bangladesh. Diagnostic delay was defined as the period from symptom onset to diagnosis of IBD. Results: Of the total 112 IBD patients 50 (44.6%) had Crohn’s disease CD and 62 (55.4%) had ulcerative colitis (UC). Males (67.9%) were predominant in the study. The median diagnostic delay was longer for patients with CD compared with patients with UC (median 24 versus 12 months; P-value 0.025). Rectal bleeding as presenting feature and male gender were negatively and positively associated with the longer diagnostic delay of IBD respectively (P-value <0.05). Of the patients with CD 14 (28%) had a history of IBD-related surgery and 7 (14%) had a history of perianal fistula. The presence of intestinal strictures, surgery, and perianal fistula at the time of diagnosis was significantly associated with long diagnostic delay for CD. Conclusion: Absence of rectal bleeding as presenting symptoms and also the male gender were the significant factors related to the longer diagnostic delay of IBD in our study. Long diagnostic delay is associated with an increased rate of complications in IBD, especially in CD. VL - 8 IS - 6 ER -
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