Dysplasia in Ulcerative Colitis Patients in Kashmir Valley

Abstract

Background:  Patients with long-standing ulcerative colitis (UC)and Crohn’s disease of the colon are at an increased risk of developing colorectal neoplasia (dysplasia and colorectal carcinoma.) In inflammatory bowel disease (IBD) the development of colorectal carcinoma (CRC) occurs through an inflammation-dysplasia-carcinoma pathway. the diagnosis and grading of dysplasia in IBD plays a decisive role in the management of patients and reducing cancer related mortality.

Aim:  To identify dysplasia in IBD patients and preventing progression to invasive colorectal carcinoma by proper intervention at right time.

Methodology: 5 years hospital based prospective study extending from June 2009 to June 2014. 

Results:  Out of 210 confirmed IBD patients 21 (10%) developed dysplasia over a period of time. All Crohn’s disease and indeterminate colitis patients were negative for dysplasia. Out of 182 ulcerative colitis patients 21 (11.53%) developed dysplasia. low grade dysplasia was present in 17 (9.34%) patients and high grade dysplasia was present in 4 (2.19%) patients. Dysplasia was higher in patients with extensive colitis and long disease duration.

Conclusion: Periodic endoscopic surveillance biopsies are must in IBD patients to rule out dysplasia and prevent progression to development of colorectal carcinoma and morbidity and mortality associated with it.