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PWE-102 Infective Diarrhoea Complicating Ibd Vs Non-ibd Patients
  1. S Mumtaz1,
  2. S Kelly1,
  3. UA Ahmad2,
  4. S Everett1
  1. 1Gastroenterology, Leeds Teaching Hospitals, Leeds, UK
  2. 2Acute Medicine, Doncaster Royal Infirmary, Doncaster, UK

Abstract

Introduction Clinical features associated with infective diarrhoea and flare up of Inflammatory Bowel Disease (IBD) are very similar and presents a challenge to gastroenterologists to distinguish the two especially at the initial presentation.

Methods This was a retrospective cohort study for patients admitted to the gastroenterology department of a single tertiary care teaching hospital with a culture positive episode of bacterial infective diarrhoea, excluding Clostridium difficile. Data was collected from clinical notes of patients presenting over an 8 year period (2004–2012). We made comparisons between the cohorts of patients with and without IBD.

Results 103 patients were included in the study; 13 had pre-existing IBD (7 UC, 6 Crohn’s), mean age [52 (17 – 82) IBD, 41 (18 – 103) non- IBD]. Organisms cultured; IBD [campylobacter 84% (11), salmonella 16% (2)], non-IBD [campylobacter 81% (73), salmonella 12% (11), ecoli 4% (4), shigella 2% (2)]. Median duration of symptoms was similar in both groups [4 days (IQR 2) IBD, 4 (IQR 6) non-IBD]. Patient gave history of (IBD vs non IBD); abdominal pain [77 vs. 90% OR 0.37 (95% CI: 0.08–1.6)], per rectal bleeding [46 vs. 52% OR 0.78 (95% CI: 0.24–2.5)], vomiting [38% vs. 43% OR 0.81 (95% CI: 0.24–2.71)]. Blood tests showed (IBD vs non IBD); platelet count [median 282 (IQR 130) vs. 237 (IQR 90)], CRP [56 (IQR 81) vs. 82 (IQR 102)], haemoglobin concentration [median 12.1 (IQR 2.4) vs. 14.3 (IQR 2.6)] and white cell count [median 8 (IQR 4) vs. 7 (IQR 3)]. A much higher proportion of patients in IBD group received steroids [77 vs 16% OR 16.6 (95% CI: 4.0–61)]. Patients in both group had comparable duration of hospital stay [median 5 (IQR 4) vs. 4 (IQR 3)].

Conclusion Infective diarrhoea presents similarly in patients who have a background of IBD to those that don’t but is more likely to be treated with steroids. A short history with abdominal pain and vomiting suggest an infective cause should be considered even if there is a established diagnosis of IBD.

Disclosure of Interest None Declared.

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