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Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
new imaging techniques may be involved in this finding. Two/third
of pts. required intestinal surgery, including jejunal surgery in one/
third of cases.
P.14.10
QUANTIFICATION OF FODMAPS INTAKE IN PATIENTS WITH
QUIESCENT INFLAMMATORY BOWEL DISEASE
Sanges M.*, Massari M., Mattera D., Sollazzo R., D’Arienzo A.
Gastroenterology Unit, Federico II University, Naples, Italy
Background and aim:
Ongoing troublesome bowel symptoms
despite quiescent inflammatory disease are a frequent management
challenge when caring for patients with Inflammatory Bowel Disease
(IBD). Even when active disease has been excluded, the prevalence
of residual gastrointestinal symptoms is surprisingly high and
the cause often obscure. Fermentable, short chain carbohydrates
(FODMAPs) have been identified as triggers for functional
gastrointestinal symptoms. Dietary restriction of FODMAPs has
been shown to reduce symptoms of bloating, gas, and diarrhea, with
placebo-controlled re-challenge confirming the role of FODMAPs
in symptom induction. The aim of our study was to evaluate the
FODMAPs intake in the usual diet of patients with IBD in quiescent
phase.
Material and methods:
A total of seventy patients with quiescent
IBD (40 with Ulcerative Colitis, 30 with Crohn’s Disease) were
enrolled in the study, and compared with a control group of forty
healthy patients. All IBD patients were in remission and on stable
treatment for at least 6 months. In all patients lactose and/or fructose
intolerance was excluded. FODMAPs intake (g/day) was evaluated
by 1-week food records. All patients with IBD were asked if they
suffered from irritable bowel syndrome (IBS) symptoms according
to Rome III Diagnostic Criteria.
Results:
We observed that IBD patients had a FODMAPs intake
significantly lower than healthy patients (20.29 ± 3.85 vs 30.91 ±
6.25; p< 0.05). According to Rome III Diagnostic Criteria, twenty-
nine (41%) of patients with quiescent IBD had IBS-like symptoms.
IBD patients without IBS-like symptoms had a FODMAPs intake
significantly lower than those with IBS-like symptoms (18.42 ± 3.56
vs 23.42 ± 3.65; p < 0.05).
Conclusions:
Our data showed that patients with quiescent IBD
had a low intake of FODMAPs in their usual diet. Moreover, patients
without IBS-like had a FODMAPs intake significantly lower than
patients with IBS-like symptoms. These results lead us to assume
that these patients tend spontaneously to exclude FODMAPs-
rich foods which could cause bowel symptoms despite quiescent
inflammatory disease.
P.14.11
METABOLIC SYNDROME: AN UNRECOGNIZED RISK FACTOR IN IBD
Serio M.*, Fioravante M., Efthymakis K., Bonitatibus A., Laterza F.,
Milano A., Neri M.
Medicine and Aging Sciences and CESI, Universita` “G. D’Annunzio”,
Chieti, Italy
Background and aim:
Metabolic Syndrome (MS) is a combination
of biochemical and anthropometric disturbances closely associated
to diseases spanning from myocardial ischemia, thrombosis
and cancer. It has been scarcely investigated and mainly in non-
caucasian patients with inflammatory bowel diseases (IBD) inspite
of the high prevalence of these complications in such patients. Yet,
similarly to what observed in other chronic inflammatory diseases,
it may be a factor affecting the prognosis and therapeutic outcome
of IBD patients. Aim of this study was to assess the prevalence of MS
in a group of IBD patients, and its association with disease activity
and therapy.
Material and methods:
125 consecutive IBD patients and 250
controls, age and sex-matched with a 2:1 ratio were enrolled during
a 1-year period. MS was diagnosed according to recent criteria
(Circulation 2009) as the presence of >3 criteria among waist
circumference, blood pressure, blood glucose, HDL, tryglicerides
levels. All IBD patients underwent ileocolonoscopy (activity was
defined according to SES-CD and Mayo scores), CRP and fecal
calprotectin (FC) were also measured (positivity cut-off respectively
>0,50 mg/dl and >150 μg/gr).
Results:
We enrolled 41 CD, 84 UC (48 M/77 F; mean age 49±17 ys)
and 250 controls (96 M/154 F; mean age 49±17 ys). MS prevalence
was higher in IBD patients than in controls (37% vs 22%, p<0.001),
slightly higher in UC than in CD (respectively 27% and10% p=ns), with
no differences between sexes. In a multivariate logistic analysis MS
was associated with IBD (OR: 4.8; 95% CI: 2,1–12.1), even in subjects
younger than 50 years (OR: 2,3;95% CI 1.2–4.5). According to disease
activity, we found no difference in SM prevalence according to
endoscopy and FC; SMwas significantly associated with CRP posivity
(72% vs 28%, p=0.006). No difference in SM prevalence during
therapy with steroid, mesalazine or immunodulator (respectively
p=0,15, p=0.35 and p=0.2); SM prevalence was lower in patients
treated with biological therapy (21% vs 44%, p=0.018), although this
effect appears to be lower in those with BMI> 30.
Conclusions:
MS should be considered in patients with IBD and
treated in terms of prevention of SM-associated diseases. In this
context a multimodal therapy which includes biologic agents seems
to be the most effective.
P.14.12
ADHERENCE TO OUTPATIENT FOLLOW-UP VISIT IN IBD PATIENTS
Vettorato M.G., Bartolo O.*, Girardin G., Rigo A., Bellia S.,
Lorenzon G., Simonetti F., Padovese F., Savarino E.V., Sturniolo G.C.,
D’Incà R.
Department of Oncological, Surgical and Gastroenterological sciences,
Padova University Hospital, Italy
Background and aim:
IBD are chronic relapsing-remitting medical
conditions requiring lifelong treatment. Non adherence to treatment
is detrimental. Improvement of pts adherence is crucial in IBD since
non-adherence has been shown to increased risk of relapse. To date,
non adherence to follow-up is poor known. The aim was to evaluate
factors that modulate non-adherence to outpatient follow-up in IBD
pts referring to a tertiary center.
Material and methods:
250 non-adherent to outpatient visit IBD
pts (NAP) for 2yrs were identified and compared with 132 pts in
regular follow-up. A structured phone interview was administered
to partecipants, investigating epidemiological and organizational
aspects, clinical data on disease activity, adherence to medical
therapy using the Morisky Scale (score <6=low, 6-7=moderate,
8= high adherence). In NAP group we evaluated quality of care
patients’perception and the reasons for non-adherence to scheduled
visits.
Results:
250 non-adherent pts (M/F 137/113; mean age 49,92
yrs±26,53) were included. Of those 136 (45.6%) were authentic non-
adherent pts (NAP-A) while 114 (36.8%) were considered false non-
adherent pts as actually in follow-up in peripheral centre (NAP-B).
132 pts (M/F 76/56, mean age 41.72±12,92 yrs) were included in the
adherent Group (AD). In NAP-A 97% were poorly symptomatic, 10,8%
followed other treatment plan, 6,8% reported social related reasons.
NAP-B pts chose peripheral centre for similar care and less wasting of
time (44%), for logistic reasons (34%) or for a more familiar approach
(22%). Most of NAP-A pts have UC (59,56%), while AD and NAP-B
have more frequently CD (respectively 57,58% and 46,49%,p<0,05.