The impact of symptoms, irritable bowel syndrome pattern and diagnostic investigations on the diagnostic delay of Crohn's disease: a prospective study

Giovanni Maconi, Laura Orlandini, Anil Kumar Asthana, Roberta Sciurti, Federica Furfaro, Cristina Bezzio, Roberto de Franchis

Research output: Contribution to journalArticleResearchpeer-review

10 Citations (Scopus)

Abstract

Background: We investigated symptoms and tests performed prior to a formal diagnosis of Crohn s disease and the reasons for diagnostic delay. Methods: Consecutive patients recently diagnosed with Crohn s disease were enrolled between October 2012 and November 2013. Clinical data, symptoms including Rome III criteria at onset and at diagnosis, location and disease phenotype were recorded. Faecal calprotectin, radiological and endoscopic examinations performed prior to diagnosis were analysed. Diagnostic delay, stratified into tertiles and median time, was analysed using parametric and nonparametric tests. Results: 83 patients (49.4 males, median age 31 years) were enrolled. The median diagnostic delay was 8 (0-324) months. Twenty-six patients did not consult a general practitioner until diagnosis (31.3 ), 18 presented to the emergency department (21.7 ) and 8 directly to a gastroenterologist (9.6 ). Diagnostic delay was not associated with specific symptoms. However, patients with bloating at presentation had a longer delay compared to those who did not (median, 6.1 vs. 16.8 months, respectively; p= 0.016).Nineteen patients underwent incomplete ileocolonoscopies (22.9 ) and 7 had no biopsies (8.4 ), with a consequent diagnostic delay (median, 24 and 24 vs. 6 months, respectively; p= 0.025 and p= 0.008). Conclusion: Diagnostic delay for Crohn s disease is significantly associated with incomplete ileocolonoscopies, but not with symptoms, except bloating at presentation
Original languageEnglish
Pages (from-to)646 - 651
Number of pages6
JournalDigestive and Liver Disease
Volume47
Issue number8
DOIs
Publication statusPublished - 2015

Cite this

Maconi, Giovanni ; Orlandini, Laura ; Asthana, Anil Kumar ; Sciurti, Roberta ; Furfaro, Federica ; Bezzio, Cristina ; de Franchis, Roberto. / The impact of symptoms, irritable bowel syndrome pattern and diagnostic investigations on the diagnostic delay of Crohn's disease: a prospective study. In: Digestive and Liver Disease. 2015 ; Vol. 47, No. 8. pp. 646 - 651.
@article{9ceb3bf248c74e358fd39f487fe96f2c,
title = "The impact of symptoms, irritable bowel syndrome pattern and diagnostic investigations on the diagnostic delay of Crohn's disease: a prospective study",
abstract = "Background: We investigated symptoms and tests performed prior to a formal diagnosis of Crohn s disease and the reasons for diagnostic delay. Methods: Consecutive patients recently diagnosed with Crohn s disease were enrolled between October 2012 and November 2013. Clinical data, symptoms including Rome III criteria at onset and at diagnosis, location and disease phenotype were recorded. Faecal calprotectin, radiological and endoscopic examinations performed prior to diagnosis were analysed. Diagnostic delay, stratified into tertiles and median time, was analysed using parametric and nonparametric tests. Results: 83 patients (49.4 males, median age 31 years) were enrolled. The median diagnostic delay was 8 (0-324) months. Twenty-six patients did not consult a general practitioner until diagnosis (31.3 ), 18 presented to the emergency department (21.7 ) and 8 directly to a gastroenterologist (9.6 ). Diagnostic delay was not associated with specific symptoms. However, patients with bloating at presentation had a longer delay compared to those who did not (median, 6.1 vs. 16.8 months, respectively; p= 0.016).Nineteen patients underwent incomplete ileocolonoscopies (22.9 ) and 7 had no biopsies (8.4 ), with a consequent diagnostic delay (median, 24 and 24 vs. 6 months, respectively; p= 0.025 and p= 0.008). Conclusion: Diagnostic delay for Crohn s disease is significantly associated with incomplete ileocolonoscopies, but not with symptoms, except bloating at presentation",
author = "Giovanni Maconi and Laura Orlandini and Asthana, {Anil Kumar} and Roberta Sciurti and Federica Furfaro and Cristina Bezzio and {de Franchis}, Roberto",
year = "2015",
doi = "10.1016/j.dld.2015.04.009",
language = "English",
volume = "47",
pages = "646 -- 651",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier",
number = "8",

}

The impact of symptoms, irritable bowel syndrome pattern and diagnostic investigations on the diagnostic delay of Crohn's disease: a prospective study. / Maconi, Giovanni; Orlandini, Laura; Asthana, Anil Kumar; Sciurti, Roberta; Furfaro, Federica; Bezzio, Cristina; de Franchis, Roberto.

In: Digestive and Liver Disease, Vol. 47, No. 8, 2015, p. 646 - 651.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The impact of symptoms, irritable bowel syndrome pattern and diagnostic investigations on the diagnostic delay of Crohn's disease: a prospective study

AU - Maconi, Giovanni

AU - Orlandini, Laura

AU - Asthana, Anil Kumar

AU - Sciurti, Roberta

AU - Furfaro, Federica

AU - Bezzio, Cristina

AU - de Franchis, Roberto

PY - 2015

Y1 - 2015

N2 - Background: We investigated symptoms and tests performed prior to a formal diagnosis of Crohn s disease and the reasons for diagnostic delay. Methods: Consecutive patients recently diagnosed with Crohn s disease were enrolled between October 2012 and November 2013. Clinical data, symptoms including Rome III criteria at onset and at diagnosis, location and disease phenotype were recorded. Faecal calprotectin, radiological and endoscopic examinations performed prior to diagnosis were analysed. Diagnostic delay, stratified into tertiles and median time, was analysed using parametric and nonparametric tests. Results: 83 patients (49.4 males, median age 31 years) were enrolled. The median diagnostic delay was 8 (0-324) months. Twenty-six patients did not consult a general practitioner until diagnosis (31.3 ), 18 presented to the emergency department (21.7 ) and 8 directly to a gastroenterologist (9.6 ). Diagnostic delay was not associated with specific symptoms. However, patients with bloating at presentation had a longer delay compared to those who did not (median, 6.1 vs. 16.8 months, respectively; p= 0.016).Nineteen patients underwent incomplete ileocolonoscopies (22.9 ) and 7 had no biopsies (8.4 ), with a consequent diagnostic delay (median, 24 and 24 vs. 6 months, respectively; p= 0.025 and p= 0.008). Conclusion: Diagnostic delay for Crohn s disease is significantly associated with incomplete ileocolonoscopies, but not with symptoms, except bloating at presentation

AB - Background: We investigated symptoms and tests performed prior to a formal diagnosis of Crohn s disease and the reasons for diagnostic delay. Methods: Consecutive patients recently diagnosed with Crohn s disease were enrolled between October 2012 and November 2013. Clinical data, symptoms including Rome III criteria at onset and at diagnosis, location and disease phenotype were recorded. Faecal calprotectin, radiological and endoscopic examinations performed prior to diagnosis were analysed. Diagnostic delay, stratified into tertiles and median time, was analysed using parametric and nonparametric tests. Results: 83 patients (49.4 males, median age 31 years) were enrolled. The median diagnostic delay was 8 (0-324) months. Twenty-six patients did not consult a general practitioner until diagnosis (31.3 ), 18 presented to the emergency department (21.7 ) and 8 directly to a gastroenterologist (9.6 ). Diagnostic delay was not associated with specific symptoms. However, patients with bloating at presentation had a longer delay compared to those who did not (median, 6.1 vs. 16.8 months, respectively; p= 0.016).Nineteen patients underwent incomplete ileocolonoscopies (22.9 ) and 7 had no biopsies (8.4 ), with a consequent diagnostic delay (median, 24 and 24 vs. 6 months, respectively; p= 0.025 and p= 0.008). Conclusion: Diagnostic delay for Crohn s disease is significantly associated with incomplete ileocolonoscopies, but not with symptoms, except bloating at presentation

UR - http://www.sciencedirect.com/science/article/pii/S1590865815003011

U2 - 10.1016/j.dld.2015.04.009

DO - 10.1016/j.dld.2015.04.009

M3 - Article

VL - 47

SP - 646

EP - 651

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 8

ER -