Evaluation of Perianal Crohns Disease using Anorectal Manometry

• Grant number: 23/01200-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: May 01, 2023
• End date: November 30, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Ligia Yukie Sassaki
• Grantee: Marina Amorim Lopes
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Background: Crohn's disease (CD) is a chronic and heterogeneous disease with uncertain and multifactor etiology due to complex interactions between environmental factors, lifestyle and genetic predisposition. It is characterized by a chronic transmural inflammation, which can compromise any part of the gastrointestinal tract. In addition, patients can present extra-intestinal manifestations of CD. More than a half of CD patients have fistulas, both internal or perianal fistulas, which are correlated to an aggressive disease presentation, with negative implications on quality of life. Perianal fistulas might provoke severe pain, fecal incontinence, anal and genital abnormalities, conditions that hardly responds to treatment. Therefore, early diagnose is important to achieve a better patient outcome. Anorectal manometry is an important tool for evaluation of anal canal, helping to diagnose and follow up on fecal incontinence. There are few studies evaluating and correlating clinical, endoscopic and laboratorial data with anorectal manometry in CD patients with perianal manifestations. Therefore, this study aims to evaluate anorectal manometry findings in those patients, analyzing them and correlating with clinical, laboratorial, endoscopic and radiologic data. Methodology: A cross-sectional, descriptive study with a quantitative approach will be developed. Patients at the IBD outpatient clinic will be invited to participate in the study. Sociodemographic data, clinical data, disease activity, use of medications, biochemical data and data from imaging exams, such as MRI, colonoscopy and anorectal manometry, will be evaluated. Statistical analysis: descriptive analysis, association tests and logistic regression. Expected Results: It is expected that this study findings helps to design a profile of patients in major risk of anal canal dysfunction, leading to an early identification, better monitoring and early diagnoses, driving the therapeutic intervention with the aim to preserve anal continence.