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SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

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Introduction

Smoking is an environmental and conductual risk factor for the development of Chron’s Disease (CD) and is associated with a more severe course of CD. In contrast, a protective effect is shown in the development and a mild course of Ulcerative Colitis (UC). Smoking leads to cardiovascular disease, cancer and other chronic diseases, and social isolation, anxiety and depression. It is also a predictor of poorer adherence to treatment in young patients.

Results & Findings

50% were women, 52 years old (SD: 12.6). 58.6% suffered CD, 39.7% more than 10 years from onset of disease, 60.7% with biologics; 54.4% in remission and 29.8% mild activity. 24% were active smokers, 60% ex-smokers and 15.5% has never smoked. 60.3% were regular exercisers, and 66% consume alcoholic beverages regularly.
Of those who smoked, 64% were women, 57% suffered CD, 46% was in remission. 85.7% with anxiety and 52.7% with depression, 61.5% perceived their health status as suboptimal. 64.3% consumed alcoholic beverages, 57.1% no physical exercise.
The mean anxiety score was 9 (SD: 3.6), depression score was 5.76 (SD: 3.7). 67.2% had anxiety levels and 32.8% depression. Perceived health status as optimal was 57.9%.
In the bilateral analysis between smoking and the independent variables, only depression and anxiety was associated.

Summary & Discussion

Smoking is an environmental risk factor for the development and course of CD. The aim of this study iis to determine smoking habits and associated factors in patients with Inflammatory Bowel Disease (IBD) in Hospital Universitario del Henares (Madrid).
A transversal study was carried out. Data were collected in a questionnaire ad-hoc and HADS.
Patients with IBD are active smokers, and their percentage is bigger to regular population in Comunidad de Madrid (21.9%). On the other hand, the percentage of ex-smokers with IBD (60%) is much higher than with no IBD; it may be related to IBD development.
It is well known the relationship between IBD and psicosocial aspects. In this study we show the high prevalence of anxiety and depression, which is higher than in general population.
Nurses can play an important role in the psychological care of patients with IBD, especially in prevention and early detection.

Conclusion

Patients with IBD showed a high tobacco consumption, most of which were women and with no healthy habits.
Smoking in patients with IBD is associated with anxiety and depression.

References

(1) Bisgaard TH, Allin KH, Keefer L, Ananthakrishnan AN, Jess T. Depression and anxiety in inflammatory bowel disease: epidemiology, mechanisms and treatment. Nat Rev Gastroenterol Hepatol. 2022;19(11):717-726.
(2) Feng L, Cai X, Zou Q, et al. Exploring the management and treatment of IBD from the perspective of psychological comorbidities. Therap Adv Gastroenterol. 2024;17:17562848241290685.
(3) Barreiro-de Acosta M, Marín-Jiménez I, Panadero A, et al. Recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) and the Association of Crohn's Disease and Ulcerative Colitis Patients (ACCU) in the management of psychological problems in Inflammatory Bowel Disease patients. Gastroenterol Hepatol. 2018;41(2):118-127.
(4) Herrero MJ, Blanch J, Peri JM, et al. A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population. Gen Hosp Psychiatry. 2003;25(4):277-83.
(5) Comunidad de Madrid. Dirección de Salud Pública. Resultados del Sistema de Vigilancia Integral del Tabaquismo (VITa). Informe 2023.

SMOKING HABITS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Dania Rocio Diaz-Rodriguez 1, Monica Granados Martin 2, Liliana La Rosa-Huertas 3, Inés Constanze Hammel 4

1 Hospital Universitario del Henares, Madrid, Spain

2 Hospital de Fuenlabrada, Fuenlabrada, Spain

3 Universidad Señor de Sipán, Lims, Peru

4 Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain

Event

UEG Week Berlin 2025

Topics

Nurses

Submission format

Abstract

Session

Abstracts II: Patient care and endoscopic techniques

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Will there be pathologists in 2030 or only AI?

Valerie Paradis 1

1 INSERM - Hôpital Beaujon, Clichy, France

Event

UEG Week Berlin 2025

Topics

Histopathology IBD Nurses

Session

The art of making clinical research precise: AI – friend or foe?

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Optimising surgical therapies in fistulising Crohn's disease

Philip J. Tozer 1

1 St Marks Hospital, London, United Kingdom

Event

UEG Week Berlin 2025

Topics

IBD Mechanisms & Personalised Medicine Surgery

Session

Focus on fistulising Crohn’s disease

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Mesenchymal stem cell therapy: All just rubbish?

Christianne Johanna Buskens 1

1 Academic Medical Center, Amsterdam, Netherlands

Event

UEG Week Berlin 2025

Topics

IBD Mechanisms & Personalised Medicine Surgery

Session

Focus on fistulising Crohn’s disease

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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PROSPECTIVE EVALUATION OF ACETIC ACID-ENHANCED MAGNIFYING ENDOSCOPY AS A SUBSTITUTE FOR CRYSTAL VIOLET STAINING IN PIT PATTERN CLASSIFICATION OF COLORECTAL EPITHELIAL NEOPLASMS

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Introduction

In colorectal epithelial neoplasms, lesions classified as type 2B according to the Japan Narrow Band Imaging (NBI) Expert Team classification (JNET), which are characterized by irregular microsurface or microvascular patterns, are often difficult to diagnose accurately using NBI magnifying endoscopy (ME) alone. Therefore, supplementary pit pattern diagnosis using crystal violet (CV)-stained ME (CV-ME) is recommended. However, CV is potentially carcinogenic, and CV-ME is relatively complex and time-consuming. Acetic acid (AA)-enhanced NBI ME (ANBI-ME) has been proposed as a simpler and safer alternative. Based on our previous study identifying 4.5% AA as the optimal concentration[1], this study prospectively evaluated the diagnostic utility of 4.5% ANBI-ME as a substitute for CV-ME (UMIN registration number: 00045621).

Aims & Methods

From October 2021 to March 2024, colorectal lesions classified as JNET type 2B or 3 during colonoscopy were prospectively enrolled until 300 cases were included. Each lesion underwent ANBI-ME with 4.5% AA, followed by CV-ME. The area of suspected deepest invasion was selected, and one representative image from ANBI-ME and one from CV-ME were independently assessed by two expert endoscopists blinded to histopathology. Intermethod and interobserver agreement were evaluated using Cohen’s weighted kappa. Diagnostic accuracy for each modality was calculated using the individual and consensus diagnoses of the two experts (McNemar’s test). AA whitening duration (AD), representing a reversible mucosal reaction, was measured during ANBI-ME and analyzed by histological depth (low-grade dysplasia [LGD], high-grade dysplasia [HGD], superficial submucosal invasive carcinoma [SMs], and deep submucosal invasive carcinoma [SMd]) using Kaplan–Meier analysis and the log-rank test.

Results

After excluding four unresected lesions, 296 lesions were analyzed. Median lesion size was 18 mm. Locations included the cecum (30), ascending colon (47), transverse colon (69), descending colon (13), sigmoid colon (73), and rectum (64); 122 lesions were elevated and 174 flat. Histological diagnosis included 77 LGD, 145 HGD, 18 SMs, and 56 SMd. Good agreement was observed between modalities (κ = 0.65 and 0.62) and between observers (κ = 0.78 for ANBI-ME, κ = 0.66 for CV-ME). Consensus was reached in 216 ANBI-ME and 192 CV-ME cases. Diagnostic accuracy was significantly higher with ANBI-ME than CV-ME for both observers (81% vs. 76%, p = 0.028; 75% vs. 69%, p = 0.025). Among consensus cases, ANBI-ME also showed higher accuracy (66% vs. 57%, p < 0.01). Median AD (in seconds) was 52 for LGD, 80 for HGD, 132 for SMs, and 107 for SMd, with a significantly shorter duration observed in LGD (p < 0.001).

Conclusion

ANBI-ME demonstrated diagnostic performance equivalent to or superior to CV-ME for colorectal lesions classified as JNET type 2B or 3. In addition, AA whitening duration (AD) may complement the assessment of histological depth of invasion.

References

[1]. Shimizu T, Yamagata T, Kanno Y, et al. A single-center pilot study on the efficacy and safety of acetic acid-enhanced magnifying endoscopy with narrow-band imaging for diagnosis of colorectal epithelial neoplasms. Gastrointest Endosc. 2025;101(2):416-424.

PROSPECTIVE EVALUATION OF ACETIC ACID-ENHANCED MAGNIFYING ENDOSCOPY AS A SUBSTITUTE FOR CRYSTAL VIOLET STAINING IN PIT PATTERN CLASSIFICATION OF COLORECTAL EPITHELIAL NEOPLASMS

Takeshi Shimizu 1, Taku Yamagata 1, Yoshihide Kanno 1, Megumi Tanaka 1, Tomohiro Shimada 1, Kai Korekawa 1, Hiroki Sato 1, Yutaka Eto 1, Yosei Sawai 1, Teruyuki Numata 1, Kei Ito 1

1 Sendai City Medical Center, Sendai, Japan

Event

UEG Week Berlin 2025

Topics

Colorectal Digestive Oncology Endoscopy

Submission format

Abstract

Session

Lower GI: Before resection comes a good characterisation

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Which advanced therapy should you choose in patients with fistulising Crohn's disease?

Krisztina Barbara Gecse 1

1 Amsterdam University Medical Center, Amsterdam, Netherlands

Event

UEG Week Berlin 2025

Topics

IBD Mechanisms & Personalised Medicine Surgery

Session

Focus on fistulising Crohn’s disease

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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ESD OF A FLAT LESION IN THE LEFT PYRIFORM SINUS MIMICKING EARLY NEOPLASIA: A DIAGNOSTIC CHALLENGE

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Introduction

Endoscopic resection techniques, particularly endoscopic submucosal dissection (ESD), are increasingly adapted for lesions located beyond the gastrointestinal tract, including the hypopharynx. Atypical lesions in the pyriform sinus are uncommon and pose significant diagnostic and therapeutic challenges due to their anatomical complexity and limited endoscopic experience. We present a rare case of a flat mucosal lesion in the left pyriform sinus, initially suggestive of low-grade dysplasia (LGD) managed by ESD for excisional biopsy. Our optical diagnosis and resection strategy were based on a previously published case by Di et al., who demonstrated the feasibility of modified ESD in the hypopharyngeal region. (BMC Cancer 17, 712 (2017).

Aims & Methods

A 28-year-old female presented with upper abdominal pain and was referred for diagnostic esophagogastroduodenoscopy (EGD). She was a non-smoker with no relevant oncological family history. Routine examination of the esophagus, stomach, and duodenum was unremarkable. However, careful inspection of the hypopharynx revealed a flat elevated lesion (Paris 0-IIa), approximately 10×10 mm in size, with a demarcated border, located in the left pyriform sinus. Under narrow-band imaging (NBI) with dual focus, intrapapillary capillary loop (IPCL) pattern type IV was observed, raising suspicion for low-grade neoplasia or high-grade neoplasia. The lesion was photo-documented, and the patient was referred for therapeutic resection.
ESD was performed under general anesthesia. En bloc excision was achieved without adverse events; the resection time was 12 minutes.

Results

Histopathologic analysis revealed stratified non-keratinizing squamous epithelium overlying subepithelial lymphoid tissue, consistent with mucosa-associated lymphoid tissue (MALT). Areas of lymphoid follicular hyperplasia with fused follicles were present. The epithelium was non-dysplastic, with regenerative changes and mild intraepithelial lymphocytosis. Immunohistochemistry revealed non-block-type p16 staining, and Ki-67 expression was limited to the basal layer. No morphological or immunohistochemical evidence of high-grade squamous intraepithelial lesion (HSIL) was found.
The patient experienced mild local discomfort for two weeks post-procedure, controlled with ibuprofen. Follow-up endoscopy at one month confirmed complete healing with no recurrence.

Conclusion

This case highlights the growing applicability of advanced endoscopic techniques beyond the gastrointestinal tract and emphasizes the diagnostic limitations of optical assessment in small hypopharyngeal lesions. Despite features suggestive of squamous dysplasia, accurate diagnosis relied on excisional biopsy. ESD proved to be a safe and effective therapeutic option in this anatomically challenging location.

References

Di, L., Fu, KI., Xie, R. et al. A modified endoscopic submucosal dissection for a superficial hypopharyngeal cancer: a case report and technical discussion. BMC Cancer 17, 712 (2017). https://doi.org/10.1186/s12885-017-3685-7

ESD OF A FLAT LESION IN THE LEFT PYRIFORM SINUS MIMICKING EARLY NEOPLASIA: A DIAGNOSTIC CHALLENGE

Ivan Hornik 1, Serhii Polishchuk 2, Hanna Lapsar 3, Vadym Korpiak 4

1 LLC "Gastrocenter", Olymed, Kyiv, Ukraine|||National University of Kyiv Mohyla Academy, Kyiv, Ukraine

2 LLC "Gastrocenter", Olymed, Kyiv, Ukraine

3 CSD Lab Medical Laboratory, Kyiv, Ukraine

4 Lisod Hospital, Kyiv, Ukraine

Event

UEG Week Berlin 2025

Topics

Digestive Oncology Endoscopy Oesophagus

Submission format

Video Case

Session

Video Case Session: Third space endoscopy

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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