74 years. The most common symptom was pain in the abdomen (74.04%). Extraintestinal manifestations were present in 12.9%. Isolated ileal involvement (49.3%) was most common. Non-stricturing, non-penetrating
disease (B1) was seen in 75.32% patients followed by stricturing, non-penetrating disease (20.77%) (B2), stricturing- penetrating (2.59%) (B3) and perianal disease (1.3%) (P). Granuloma was seen in only 7.79% of the patients. 74.43% patients had mild-moderate disease at presentation while 6.3% of the patients had severe – fulminant presentation. Conclusion: CD is common in Asian regions. There are some U0126 supplier notable epidemiological and phenotypic differences in CD patients of Indian origin as compared with those of Caucasian origin, the former showing lack of familial clustering, male predominance,
and higher age of onset. Key Word(s): 1. Crohn’s Disease; Presenting Author: STEEN VADSTRUP Additional Authors: IBENASMUSSEN LISBJERG, selleck compound JEANETTE JENSEN Corresponding Author: STEEN VADSTRUP Affiliations: Holbaek Hospital Objective: Use of anti-diarrhoeal agents (AD) has been strongly discouraged in treatment of clostridium difficile infections (CDI). In a survey of the literature Koo et al. (clin infect dis 2009) only found reports of 55 patients subjected to treatment with anti-motility agents. Colon dilatation developed in 17 of which 5 died, however only patients, who were initially treated with anti-motility agents experienced severe complications. If the patients were treated with antibiotics before receiving anti-motility agents, no complications occurred (N = 23) Methods: Based on this information we have since april 2011 treated all our patients with CDI with vancomycin supplied with AD as soon as the vancomycin effect was detected by decreasing infection parameters. We have also used budesonide since we have experienced that patients with microscopic colitis who developed CDI had their microscopic colitis re-activated
and budesonide had a favourable effect on CDI. We used 3 AD, loperamide (L) budesonide (B) and questran (Q) and started almost all with L, added Phosphoribosylglycinamide formyltransferase B and sometimes Q, until the diarrhoea stopped. Then we continued with one or two as long as vancomycin was administered. Results: From april 2011 to april 2013 we treated 32 patients with CDI, about 50 % produced toxins. Mean age 73 years (51–87) F/M ratio 19/13., 26 received L, 14 also B and 7 also Q. Two patients received no AD. Only one patient died from preexisting cardiac complications still positive for CD. The other patients we discharged without signs of CDI and without diarrhoea. Length of stay 14 days (3–40) None experienced new CDI. Conclusion: AD agents are not dangerous in DCI, on the contrary outcome is improved when AD agents are added after start of vancomycin treatment. Key Word(s): 1. colitis; 2. clostridium diff.; 3. anti-diarrhoeal; 4.