Frequency and Characteristics of Anorectal Pathologies in Patients With Inflammatory Bowel Disease
Background:
Inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), commonly manifests with gastrointestinal symptoms such as diarrhea and abdominal pain. Anorectal complications are more prevalent in CD and less frequent in UC. In CD, perianal involvement is a significant clinical concern, with the development of abscesses and fistulas that can complicate disease management. Additionally, benign anorectal conditions such as hemorrhoids and fissures are commonly observed. Managing anorectal pathologies in IBD is complex and may require anything from topical medications to surgery in severe cases. A comprehensive approach is essential to address both intestinal symptoms and perianal complications. The aim of this study is to describe the frequency and characteristics of anorectal pathologies in patients with IBD from the IBD Clinic of the General Hospital of Mexico “Dr. Eduardo Liceaga.”
Methods:
In a retrospective observational study at the IBD Clinic of the Hospital General de Mexico, 184 patients with IBD were analyzed over 12 months. Clinical and demographic data, diagnoses, treatments, and anorectal pathologies were evaluated. SPSS version 29 was used for statistical analysis, highlighting measures of central tendency, frequency distribution, and the Chi-square test for inferential analysis.
Results:
In our study, the demographic and clinical characteristics of patients with IBD were evaluated, highlighting that 31.5% had anorectal pathologies (ARP). The most common among these were hemorrhoidal disease (16.8%), fistulas (6%), and anal fissure (3.3%). In the subgroup of patients with UC and ARP (n=46), males predominated (52.2%) with an average age of 40.13 years. Hemorrhoids (56.5%) were the most common ARP. In the group with CD and ARP (n=12), females predominated (83.3%) with an average age of 45.75 years, with fistulas (50%) being the most prevalent ARP. Medical treatment was effective in most cases (91.3% in UC, 75% in CD), with a small percentage requiring surgical treatment. No statistically significant differences were found in the characteristics between the IBD groups with and without ARP (<italic>P ></italic> 0.05).
Conclusions:
The study highlighted a high prevalence of anorectal pathologies (31.5%) in patients with IBD, including hemorrhoidal disease, fistulas, and anal fissures. Differences in incidence were observed according to the type of IBD, with a higher presence of fistulas in CD. Most patients responded well to medical treatment, although some required surgery. These results underline the importance of comprehensive approaches in the management of IBD, focusing on adequately evaluating and treating perianal complications to improve quality of life.
