Clinical characteristics and short-term outcome of surgically managed inflammatory bowel disease patients: an experience from SPHMMC, Addis Ababa Ethiopia

Abstract

Executive Summary Background: Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract (GI), which is characterized by a disrupted mucosal structure, altered gut microbial composition, and systemic biochemical abnormalities. The two main diseases of inflammatory bowel disease are Crohn's disease and ulcerative colitis. The pathogenesis of inflammatory disease is that abnormal intestinal inflammations occur in genetically susceptible individuals according to various environmental factors. The consequent process results in inflammatory bowel disease. Most common clinical presentation include diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss. Medical treatment consists of the induction of remission in the acute phase of the disease and the maintenance of remission. Patients with Crohn's disease finally need surgical treatment in 70% of the cases. The overall 1, 5, 10 years risk of surgery is 18.7%, 28.0%, and 39.5% respectively [*]. The main surgical options for Crohn's disease are divided into two surgical procedures. The first is strictureplasty, which can prevent short bowel syndrome. The second is resection of the involved intestinal segment. Simultaneous medico-surgical treatment can be a good treatment strategy. Ulcerative colitis is a diffuse nonspecific inflammatory disease that involves the colon and the rectum. Patients with ulcerative colitis need surgical treatment in 30% of the cases despite proper medical treatment. Similarly, the overall 1, 5, 10 years risk of colectomy was 4.0%, 8.8% and 13.3% respectively [*]. The reasons for surgical treatment are various, from life threatening complications to growth retardation. The total proctocolectomy (TPC) with an ileal pouch anal anastomosis (IPAA) is the most common procedure for the surgical treatment of ulcerative colitis. Medical treatment for ulcerative colitis after a TPC with an IPAA is usually not necessary. Objective: to evaluate the clinical characteristics and short-term outcome of surgically managed inflammatory bowel disease (IBD) patients at SPHMMC, Addis Ababa Ethiopia. Methods: This is a cross-sectional study to examine the data of individuals with Inflammatory bowel disease who are managed surgically. A questionnaire will be used to collect data, and SPSS version 28 will be used to compute descriptive statistics, correlation, and regression analysis to test for the rate of surgery for IBD and short -term outcome including complication rate after surgery. P-values of less than 0.05 shall be considered statistically significant. Timeframe: February 2021 to March 2024. Estimated Budget: The estimated budget required to conduct this study is 28,200 ETH Birr. Keywords: Inflammatory bowel disease, ulcerative colitis, Crohn’s disease, short-term surgical outcome