Abstract
Background
Untimely diagnosis increases the number of severe forms of IBD, which enlarges the possibility of life-threatening complications, extraintestinal presentations, and the patient’s need for surgical treatment.
Methods
We analysed the data of 1130 patients with an established diagnosis of UC or CD. The dynamics of the timing of diagnosis of IBD, the nature of the disease, the frequency of occurrence of intestinal complications, extraintestinal presentations were evaluated.
Results
The maximum frequency of start of both UC and CD falls on the young age of patients - from 19 to 38 years. The duration of symptoms before diagnosis is established is 2.3 years (27.4 months) for CD, 1.1 years (12.1 months) for UC. 81.8% of patients with UC are diagnosed no more than 4 years, but in 10.9% of patients this interval was 4–9 years; in 3.6%, 9–13 years; in 1.9%, 13–18 years, and in another 1.8%, more than 20 years. In CD 59.5% of patients fall into the diagnosis interval up to 4 years, in 27.4% this period takes from 4 to 9 years, in 7%—10–15 years, and in 6% more than 6 years. At the age of 18–25 years severe course of IBD is observed in 12% of patients, at the age of 26–30 years—in 18%, 31–40 years—in 9%. Older people are more likely to experience mild IBD, and the percentage of severe and moderate forms is 4% and 29%, respectively, after 60, and less than 0.5% and 19.5%, respectively, after 70 years. Extraintestinal presentations were observed in 43.4% of patients, with 25% of them having more than one of them. In patients with CD, the development of complications in the first 4 years of the disease was noted in 62%, in UC—in 58.9%. In patients with intestinal complications, the diagnosis period was 2.9 years, without them—2.4 years. However, in patients with a history of surgical treatment of IBD, the diagnosis period was less than 1 year. 69, 3% of revealed patients with a history of needing one or more hospitalisations associated with IBD, and 15.8% underwent surgery for IBD.
Conclusion
Based on the data obtained, it can be concluded that the main part of complications occurs in the first few years after the onset of the disease. With late diagnosis, the probability of developing not only intestinal complications, but also extra-intestinal presentations significantly increase, which reflects a more severe form of the disease. The shorter time of diagnosis of IBD in patients who need surgical treatment is explained by more pronounced symptoms that require urgent medical care. However, the proportion of IBD with severe and moderate form is greater in young age groups, and as the ‘growing up’ groups - the number of patients with mild IBD begins to prevail.
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