CLINICAL SPECTRUM OF ULCERATIVE COLITIS IN KASHMIRI POPULATION: FOUR YEARS EXPERIENCE IN A TERTIARY CARE HOSPITAL
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Keywords
Ulcerative colitis, Montreal classification, Biological.
Abstract
Background: Diagnosing ulcerative colitis (UC) in developing countries with limited healthcare facilities and high endemicity for parasitic infestations, infective diarrhea, and functional gastrointestinal disorders is challenging. Understanding the clinical and epidemiological profile of patients with UC can facilitate the recognition of disease burden, patterns, and treatment responses, thereby rationalizing management approaches. Data on this topic are scarce in Jammu and Kashmir. No studies have been conducted in the Kashmir division, where significant genetic and environmental influences exist, which is similar to the rest of India. This study aimed to identify the clinical and epidemiological profiles of patients attending a tertiary care hospital in the Kashmir Valley.
Methods: The present study was a hospital-based prospective cross-sectional observational investigation conducted in the Department of Gastroenterology, GMC Srinagar, Jammu, and Kashmir, India. All 114 consecutive newly diagnosed patients aged ≥ 17 years were enrolled over 49 months from December 2019 to January 2024. The demographic characteristics and clinical profiles of the patients were examined.
Results: In total, 114 newly diagnosed patients were included. Seventy-eight (59.6%) patients were males and forty-six (40.4%) females. The mean age of the patients at diagnosis was 38 years. The most prevalent symptom was hematochezia (63.2%), followed by chronic diarrhea (28%). A family history was observed in 12 patients (10.5 %). Eighty-two patients (71.9 %) required hospital admission for complicated UC. Joint involvement (25%) was the most common extra-intestinal manifestation (EIM), followed by cutaneous and oral involvement (6%). Surgical intervention during follow-up was necessary for 8.8% of the patients. Corticosteroids and azathioprine were administered to 58 patients (67 %), followed by biological agents in 10 patients (8.8%). Novel Janus kinase (JAK) inhibitors were used in 36 (31.6%) patients after azathioprine intolerance or treatment failure. The most frequent disease location was the left-sided colitis. One hundred and eight patients achieved remission, while six died.
Conclusions: This study represents the first investigation into the clinical and demographic profile of UC in Kashmir Valley, India. The higher prevalence of complicated UC necessitates greater utilization of healthcare resources in this cohort, including hospitalization, surgery, and biological treatment.
References
Bibliography
1. Loftus, E. V., Silverberg, M. S., & Sandborn, W. J. (2021). Epidemiology of inflammatory bowel disease: A systematic review of the global literature. Alimentary Pharmacology & Therapeutics, 53(1), 123–139.
2. Ng, S. C., Shi, H. Y., Hamidi, N., Underwood, F. E., Tang, W., Benchimol, E. I., ... & Kaplan, G. G. (2020). Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies. The Lancet, 390(10114), 2769–2778.
3. Turner, D., & Levine, A. (2021). Current and emerging treatments for ulcerative colitis. Gut, 70(1), 14–29.
4. Thompson, A. I., Lees, C. W., & Barrett, J. C. (2019). Genetic and environmental factors in the pathogenesis of inflammatory bowel disease. Nature Reviews Gastroenterology & Hepatology, 16(4), 197–210. Kaplan, G. G., & Ng, S. C. (2017).
5. Lee, S. H., Kwon, J. E., & Kim, K. H. (2018). Factors influencing hospitalization in patients with ulcerative colitis: A retrospective cohort study. Digestive Diseases and Sciences, 63(6), 1524–1530
6. Sandborn, W. J., Feagan, B. G., & Hanauer, S. B. (2020). Advances in biologic therapy for ulcerative colitis. New England Journal of Medicine, 381(16), 1483–1496.
7. Ungaro, R., Mehandru, S., Allen, P. B., Peyrin-Biroulet, L., & Colombel, J. F. (2019). Ulcerative colitis. The Lancet, 389(10080), 1756–1770.
8. Kaplan, G. G., & Ng, S. C. (2017). Understanding and preventing the global increase of inflammatory bowel disease. Gastroenterology, 152(2), 313–321.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Waseem Javid
Department of Medical Gastroenterology and Hepatology, Government Medical College, Srinagar 190010, India.
Qazi Aamir
Department of Medical Gastroenterology and Hepatology, Government Medical College, Srinagar 190010, India.
Showkat A. Kadla
Department of Medical Gastroenterology and Hepatology, Government Medical College, Srinagar 190010, India.
Nisar A. Shah
Department of Medical Gastroenterology and Hepatology, Government Medical College, Srinagar 190010, India.