Extraintestinal Manifestations Of Ulcerative Colitis In Saudi Arabia: Systematic Review

Authors

  • Talal Alhejaili
  • Raghad Albdair
  • Abdulrahman Saleem Alhweiti
  • Ali Mohammed Ayed Almutairi
  • Luluah Maan Alaqbawi
  • Shahad Zaid N. Alanazi
  • Haya Abdulrhman AlAzmi
  • Mohammad Mahmoud Obidan Albalawi
  • Khalaf Fayiz Alhowaish
  • Sanad Khalf M. Alshammari
  • Fadhel Abdullah Fadhel Alshammari
  • Atheer Abdullah A Alkhulaif
  • Yaser Yasen M Alnaser

DOI:

https://doi.org/10.53555/jaz.v44i4.3087

Keywords:

Ulcerative colitis, Extraintestinal manifestations, Saudi Arabia, Arthropathy, Bone complications

Abstract

Background: Inflammatory bowel disease (IBD), particularly ulcerative colitis (UC), exhibits varied clinical presentations and extraintestinal manifestations (EIMs) that impact the overall well-being of affected individuals. This systematic review aims to consolidate recent studies conducted in Saudi Arabia to comprehensively analyze the sociodemographic characteristics and clinical features of UC patients, with a specific focus on bone-related complications.

Objective: To systematically review Extraintestinal Manifestations of Ulcerative Colitis in Saudi Arabia

Methodology: Using the PRISMA guidelines, a comprehensive A systematic search was conducted to identify relevant studies published between 2014 and 2023 on PubMed in English that investigated UC in Saudi Arabia. resulting in the inclusion of seven studies with a collective participant count of 1580. Sociodemographic characteristics & Clinical characteristics, particularly the prevalence of bone-related complications, were examined across these studies.

Results: The sociodemographic analysis of 1580 participants from seven studies highlighted variations in extraintestinal manifestations in IBD. Due to the inflammatory nature of the UC disease, and increased glucocorticoids concentrations, bone-related complications, including osteoporosis and osteopenia, were prevalent in UC patients, with distinct patterns observed in different studies. Arthropathy emerged as one of the most common extraintestinal manifestation. Moreover, renal stones are another issue for these patients. Finally, all of these manifestations contribute to the prevalence of anxiety and depression symptoms that was identified among UC patients, that indicated that fifth of these cohort suffer from, psychological disease.

Conclusion: This systematic review provides a comprehensive overview of recent studies on UC in Saudi Arabia, emphasizing the prevalence of bone-related complications as predominant extra intestinal manifestations. The findings underscore the importance of addressing these complications in the management of UC patients, necessitating regular testing of the bone density in these patients and provide supplements and other necessary treatments for these patients. Moreover, it is important to consider the psychological impact of such disease on the quality of life of patients. Comprehensive multi-disciplinary medical teams need to work together to address various clinical aspects regarding Ulcerative colitis. This does not only include gastroenterologist, nephrologists and general internists, but also include psychologists/therapists to ensure all patients needs are addressed. Finally, further research is needed to have comprehensive view of UC in Saudi Populations and improve the overall quality of care.

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Author Biographies

Talal Alhejaili

Consultant Internal Medicine; Gastroenterology, King Salman Medical City, Madina, Saudi Arabia

Raghad Albdair

General practitioner, King Salman Medical City, Madina, Saudi Arabia

Abdulrahman Saleem Alhweiti

General Practitioner, King khalid Hospital, Tabuk, Saudi Arabia

Ali Mohammed Ayed Almutairi

General practitioner, Emergency Department, King Salman Medical City, Madina, Saudi Arabia

Luluah Maan Alaqbawi

General Practitioner, Maternity and Children hospital, Arar, Saudi Arabia

Shahad Zaid N. Alanazi

General Practitioner, Maternity and Children hospital, Arar, Saudi Arabia

Haya Abdulrhman AlAzmi

General physician, Prince Sultan Military Medical City, Riyadh, Saudi Arabia

Mohammad Mahmoud Obidan Albalawi

General Practice, King Khalid Hospital, Tabuk, Saudi Arabia

Khalaf Fayiz Alhowaish

Dentist, Ministry of Health Hospitals, Arar, Saudi Arabia

Sanad Khalf M. Alshammari

Faculty of Medicine, Northern Bord

er University, Arar, Saudi Arabia

Fadhel Abdullah Fadhel Alshammari

 

Faculty of Medicine, Northern Border University, Arar, Saudi Arabia

Atheer Abdullah A Alkhulaif

Faculty of Medicine, Northern Border University, Arar, Saudi Arabia

Yaser Yasen M Alnaser

Faculty of Medicine, Northern Border University, Arar, Saudi Arabia

 

References

Levine, J. S., & Burakoff, R. (2011). Extraintestinal manifestations of inflammatory bowel disease. Gastroenterology & hepatology, 7(4), 235–241.

Rothfuss KS, Stange EF, Herrlinger KR. Extraintestinal manifestations and complications in inflammatory bowel diseases. World J Gastroenterol. 2006 Aug 14;12(30):4819-31.

Trikudanathan G, Venkatesh PG, Navaneethan U. Diagnosis and therapeutic management of extra-intestinal manifestations of inflammatory bowel disease. Drugs. 2012 Dec 24;72(18):2333-49.

Vavricka SR, Brun L, Ballabeni P, Pittet V, Prinz Vavricka BM, Zeitz J, Rogler G, Schoepfer AM. Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. Am J Gastroenterol. 2011 Jan;106(1):110-9.

Rogler, G., Singh, A., Kavanaugh, A., & Rubin, D. T. (2021). Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management. Gastroenterology, 161(4), 1118–1132. https://doi.org/10.1053/j.gastro.2021.07.042

Sange, A. H., Srinivas, N., Sarnaik, M. K., Modi, S., Pisipati, Y., Vaidya, S., Syed Gaggatur, N., & Sange, I. (2021). Extra-Intestinal Manifestations of Inflammatory Bowel Disease. Cureus, 13(8), e17187. https://doi.org/10.7759/cureus.17187

Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic reviews, 5(1), 1-10.

Jüni, P., Loke, Y., Pigott, T., Ramsay, C., Regidor, D., Rothstein, H., ... & Shea, B. (2016). Risk of bias in non-randomized studies of interventions (ROBINS-I): detailed guidance. Br Med J

Mosli, M. H., & Saadah, O. I. (2021). Metabolic bone disease in children and adolescent patients with ulcerative colitis. Jornal de pediatria, 97(2), 242–247. https://doi.org/10.1016/j.jped.2020.03.003

Adam, H., Alqassas, M., Saadah, O. I., & Mosli, M. (2020). Extraintestinal Manifestations of Inflammatory Bowel Disease in Middle Eastern Patients. Journal of epidemiology and global health, 10(4), 298–303. https://doi.org/10.2991/jegh.k.200330.001

Mosli, M., Alzahrani, A. M., Bahafzalla, R. A., Gazzaz, T. A., Slaghour, R. M., Altabsh, G. Z., Aljadani, S. B., Alturkestani, R. N., Hussein, S. S., Kashgary, A., & Saadah, O. I. (2021). Prevalence of Renal Stones Among Patients With Inflammatory Bowel Disease in Saudi Arabia. Cureus, 13(6), e15787. https://doi.org/10.7759/cureus.15787

Alharbi, O. R., Azzam, N. A., Almalki, A. S., Almadi, M. A., Alswat, K. A., Sadaf, N., & Aljebreen, A. M. (2014). Clinical epidemiology of ulcerative colitis in Arabs based on the Montréal classification. World journal of gastroenterology, 20(46), 17525–17531. https://doi.org/10.3748/wjg.v20.i46.17525

Al-Fawzan, A. A., Al-Radhi, S. A., Al-Omar, A. S., Al-Mutiri, N. H., Al-Ammari, A. M., El-Gohary, M., Shamsan, A. N., Al Shehri, H. M., & ALGhasab, N. S. (2023). A Study of the Epidemiology, Clinical, and Phenotypic Characteristics of Inflammatory Bowel Disease in the Northen-Central Region of Saudi Arabia. Diagnostics (Basel, Switzerland), 13(13), 2135. https://doi.org/10.3390/diagnostics13132135

Alreheili, K. M., Alsaleem, K. A., & Almehaidib, A. I. (2018). Natural history and outcome of inflammatory bowel diseases in children in Saudi Arabia: A single-center experience. Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, 24(3), 171–176. https://doi.org/10.4103/sjg.SJG_490_17

Alnafisah, K., Alsaleem, H. N., Aldakheel, F. N., Alrashidi, A. B., Alayid, R. A., Almuhayzi, H. N., & Alrebdi, Y. M. (2023). Anxiety and Depression in Patients With Inflammatory Bowel Disease at King Fahad Specialist Hospital, Qassim Region. Cureus, 15(9), e44895. https://doi.org/10.7759/cureus.44895

. Hidalgo D.F., Boonpheng B., Phemister J., Hidalgo J., Young M. Inflammatory bowel disease and risk of osteoporotic fractures: a meta-analysis. Cureus. 2019;11:e5810

Tsai M.S., Lin C.L., Tu Y.K., Lee P.H., Kao C.H. Risks and predictors of osteoporosis in patients with inflammatory bowel diseases in an Asian population: a nationwide population-based cohort study. Int J Clin Pract. 2015;69:235–241.

Neelis E., Rijnen N., Sluimer J., Olieman J., Rizopoulos D., Wijnen R., et al. Bone health of children with intestinal failure measured by dual energy X-ray absorptiometry and digital X-ray radiogrammetry. Clin Nutr. 2018;37:687–694.

Vavricka SR, Brun L, Ballabeni P, Pittet V, Vavricka BMP, Zeitz J, et al. Frequency and risk factors for extraintestinal manifestations in the Swiss inflammatory bowel disease cohort. The Am J Gastroenterol. 2011;106:110–19. doi: 10.1038/ajg.2010.343.

Singh B, Kedia S, Konijeti G, Mouli VP, Dhingra R, Kurrey L, et al. Extraintestinal manifestations of inflammatory bowel disease and intestinal tuberculosis: frequency and relation with disease phenotype. Indian J Gastroenterol. 2015;34:43–50. doi: 10.1007/s12664-015-0538-7

Greenstein AJ, Janowitz HD, Sachar DB. The extraintestinal complications of Crohn's disease and ulcerative colitis: A study of 700 patients. Medicine. 1979;55:410–2.

15. Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: A population-based study. Am J Gastroenterol. 2001;96:1116–22

Mendoza JL, Lana R, Taxonera C, Alba C, Izquierdo S, Díaz-Rubio M. Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn's disease and ulcerative colitis. Med Clin (Barc) 2005;125:297–300

Jose FA, Garnett EA, Vittinghoff E, Ferry GD, Winter HS, Baldassano RN, et al. Development of Extraintestinal Manifestations in Pediatric Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2009;15:63–8.

Grossman BJ, DeBenedetti CD. Extraintestinal manifestations of chronic inflammatory bowel disease in children. Proc Inst Med Chic. 1970;28:119.

Stawarski A, Iwanczak B, Krzesiek E, Iwanczak F. Intestinal complications and extraintestinal manifestations in children with inflammatory bowel disease. Pol Merkur Lekarski. 2006;20:22–5

Lima, C. A., Lyra, A. C., Rocha, R., & Santana, G. O. (2015). Risk factors for osteoporosis in inflammatory bowel disease patients. World journal of gastrointestinal pathophysiology, 6(4), 210–218. https://doi.org/10.4291/wjgp.v6.i4.210

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Published

2023-10-29

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