Abstract

PROSPECTIVE OBSERVATIONAL STUDY ON SYMPTOMATIC INFLAMMATORY BOWEL DISEASE AND THERAPEUTIC MANAGEMENT

Gurka Sai Krishna*, Dr. Srinivas Rao, Dr. Ravi Shanker and Dr. AV. Kishore Babu

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Abstract

Introduction: Inflammatory Bowel Disease (IBD) is A Disorder involving long standing chronic inflammation of tissues in digestive tract. It commonly used to describe two forms of idiopathic diseases of the gastro intestinal tract, namely Ulcerative Colitis(UC) and Crohn’s Disease(CD). UC involves in rectum and colon and lesions involved in primary mucosa and sub mucosa. CD involves from mouth to anus involving transmural inflammation that leads to fistula and strictures.[1] Patients report gastrointestinal symptoms of abdominal pain, diarrhea, and rectal bleeding as well as systemic symptoms of weight loss, fever, and fatigue.[2] The etiologies of both conditions are unknown. Although, factors such as age, race and diet, smoking, infection, enteric microflora, excessive use of drugs like non steroidal anti inflammatory medications, appendicectomy, stress, genetics, ethnic and familial factors may play a vital role.[3] Methodology: It is a six month prospective observational study that was carried out with teritiary hospital with the institutional ethical committee (IEC) approval. The subjects i.e Patients who meet the required study criteria are considered to take part. Patient’s case reports, lab investigation reports, and medical records were used to gather the necessary information following the receipt of informed consent form from patients and their informants (primary care givers). The gathered information will be analyzed to understand the clinical symptoms, site of gastrointestinal tract affected and different prescribing patterns in the management of IBD (UC & CD). Results: Our research found that most common symptom in UC patients were blood in stools(80.7%) and abdominal pain(73.07%) followed by diarrhea (73.07%), loss of appetite (73.07%), weight loss(69.2%), fatigue(57.6%), urgency (26.9%) nausea/ vomiting(15.3%), mouth ulcer(7.69%). Our research found that most common symptom in CD patients were abdominal pain(91.6%), weight loss(83.3%), diarrhea (75%), fatigue(58.3%), and followed by loss of appetite (54.16%), blood in stools(37.5%), nausea/ vomiting(37.5%), urgency (29.16%), arthritis(16.66%), mouth ulcer(8.33%). In my research, it was evident that most number of patients with UC were treated with dual therapy which included aminosalicylates and immunosuppressants and patients with CD were treated with triple therapy. Biologics were included in tripletherapy for patients who had severe form of the disease. Other drugs such as probiotics, cortecosteroids, Proton pump inhibitors, antibiotics, multivitamins, iron supplements and other analgesics were also prescribed to the patients. my study results have shown that the patients who had presented with mild condition of disease were mostly treated with aminosalicylates (monotherapy). In moderate conditions, patients were treated with corticosteroids and immunosuppressants (dualtherapy). Severe condition disease patients were treated with biologics (triple therapy) and (quadraple therapy). Conclusion: In my study, it was observed that Ulcerative Colitis and Crohn’s disease is more prevalent in males than in females. The greatest incidence is reported in the same age group of 19-28 years old for both UC and CD. Blood in stool and abdominal pain were the most common symptoms of UC and CD patients with anemia being the most common complication for both. IBD is a long term illness that requires good therapy adherence. Non adherence has been linked to a higher likelihood of relapse, a greater risk of colorectal cancer, a lower quality of life and significantly higher health care expenses. As a result, promoting drug adherence is an essential strategy for improving IBD clinical outcomes. More research is required to assess the prescribing patterns for patients whose condition is worsening.

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