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Extraintestinal manifestations in inflammatory bowel disease: Prevalence and predictors in Indian patients

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Abstract

Background

There is a paucity of reports on extraintestinal manifestations (EIMs) in patients with inflammatory bowel diseases (IBD) from Asia and India.

Methods

From May 2011 to October 2012, consecutive IBD patients underwent a detailed history and physical examination, also by trained rheumatologist, dermatologist, and ophthalmologist, about whether they experienced any EIM at the time of inclusion or in the past. The disease phenotype/severity and location was classified according to the Montréal classification. All underwent magnetic resonance imaging (MRI) of sacroiliac joints, liver function test (LFT), transabdominal ultrasound, and dual energy X-ray absorptiometry (DEXA) scanning at neck femur (bilateral) and L4-L5 spine.

Results

One hundred twenty patients were analyzed, 62 had Crohn’s disease (CD) and 58 had ulcerative colitis (UC). Thirty-eight percent had at least one while 20 % suffered from multiple EIMs. Except for uveitis and episcleritis, the frequency of individual EIMs did not differ between CD and UC patients. Twenty-three percent had peripheral arthritis, 18 % had ankylosing spondylitis, and 13 % had ophthalmological manifestations. Mucocutaneous manifestations, aphthous stomatitis and pyoderma gangrenosum (PG), were seen in 9 %. None had erythema nodosum (EN) or primary sclerosing cholangitis (PSC). Fifty percent of patients had either osteopenia or osteoporosis on DEXA. Multivariable analysis revealed female gender, Hindu religion, severe disease, and steroid usage were significantly associated with the presence of EIMs.

Conclusion

The prevalence of EIM is similar to that reported from Europe and USA, albeit higher than that previously reported in Asian patients. Female sex, religion, severe disease, and steroid use were associated with EIM.

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Acknowledgments

We thank the Department of Health and Family Welfare, Government of West Bengal, India, for their support and encouragement and providing the infrastructure to carry out this study. We thank Dr. David B Sachar for critically reviewing the data. The study did not receive any direct funding.

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Authors and Affiliations

  1. Division of Gastroenterology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India

    Debottam Bandyopadhyay, Sanjay Bandyopadhyay, G. K. Dhali & Kshaunish Das

  2. Department of Rheumatology, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India

    Parasar Ghosh

  3. Department of Dermatology, Institute of Post Graduate Medical Education and Research, 244 A J C Bose Road, Kolkata, 700 020, India

    Abhishek De

  4. All India Institute of Hygiene and Public Health, 27 and 27 B, J C Block, Salt Lake City, Sector 3, Kolkata, 700 098, India

    Anupam Bhattacharya

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  1. Debottam Bandyopadhyay
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Correspondence to Kshaunish Das.

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Conflict of interest

DB, SB, PG, AD, AB, GKD, and KD declare that they have no competing interests.

Ethics statement

The study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008, concerning Human and Animal Rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Bandyopadhyay, D., Bandyopadhyay, S., Ghosh, P. et al. Extraintestinal manifestations in inflammatory bowel disease: Prevalence and predictors in Indian patients. Indian J Gastroenterol 34, 387–394 (2015). https://doi.org/10.1007/s12664-015-0598-8

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  • DOI: https://doi.org/10.1007/s12664-015-0598-8

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