Characteristics and associations of Ulcerative colitis in Pakistani population.

Abstract

Objectives: To determine the prevalence of ulcerative colitis, extent and associations of disease with age, gender, indication of the procedure and coexisting disorders in patients who underwent sigmoidoscopy at Liver Clinic, Lahore, Pakistan. Study Design: Retrospective study. Setting: Liver Clinic, Lahore. Period: February 2010 to July 2017. Material & Methods: Group of ulcerative colitis patients was compared with group without ulcerative colitis among who underwent sigmoidoscop     y from genders, age groups, indication for sigmoidoscopy, and presence of ulcerative colitis were the qualitative variables, while age of the patients was the only quantitative variable. Data was analysed on SPSS-25was used. Means with standard deviations were computed of quantitative variables, and frequencies-percentages for qualitative variables. Chi-square test for independence and Independent sample T test were used for qualitative and quantitative variables respectively to determine their significant association with presence of ulcerative colitis. The p values were taken statistically significant if < 0.05. Results: Out of total of 998 patients who underwent sigmoidoscopy, 115 (11.52%) had ulcerative colitis. The mean age of ulcerative colitis patients was 37.87 + 14.23 years while mean age of patients not suffering ulcerative colitis was 44.42 + 15.29 years. Among ulcerative colitis suffering cohort, 6.1% were children, 41.7% young adults, 44.3% middle aged adults and 7.8% were older adults. Out of 115 patients, 22 (19.1%) had ulcerative proctitis, 25 (21.7%) ulcerative proctosigmoiditis and in remaining 68 (59.1%) patients had colitis throughout visualized tract. 29 (25.2%) ulcerative colitis patients had supplementary associated disorders: 11 (37.9%) had superimposed pseudomembranous colitis, 8 (27.6%) had pseudopolyps formation, 7 (24.1%) had solitary benign polyps, 2 (6.9%) had internal hemorrhoids and 1 (3.4%) had malignant growth as well. The ulcerative colitis was more prevalent in female gender (p<0.01), younger age group (p<0.01) and where bloody diarrhea was presenting complaint (p<0.01). Conclusion: Ulcerative colitis is prevalent in all age groups and female gender is more affected in our population. Majority patients have disease not limited to only rectum and sigmoid colon, rather possess aggressive disease pattern associated with more risks and hazards. Ulcerative colitis usually presents with bloody diarrhea in our people. There are multiple coexisting disorders, where higher prevalence of pseudomembranous colitis in ulcerative colitisdemands avoidance of undue antibiotics and better hygiene.