A0385 - Patients With Neuro-Developmental Disorders Are Associated With a Higher Risk of Inflammatory Bowel Disease: A Nationwide Population-Based Study

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Ahmed Eltelbany, MD, MPH

Cleveland Clinic
Cleveland, OH

Ahmed Eltelbany, MD, MPH¹, Khaled Alsabbagh Alchirazi, MD¹, Osama Hamid, MD, MRCPI¹, Abdul Mohammed, MD¹, Rama Nanah, MD¹, Miguel Regueiro, MD²
¹Cleveland Clinic, Cleveland, OH; ²Cleveland Clinic Main Campus, Cleveland, OH

Introduction: Previous studies have suggested that patients with neurodevelopmental disorders (NDD) were much more likely to report gastrointestinal symptoms such as abdominal pain or diarrhea. Gut microbiota is influential in brain development and behaviors and inflammatory bowel disease (IBD) is known to induce gut inflammation and microbiota dysbiosis. The objective of this study was to investigate the prevalence of inflammatory bowel disease (IBD) among patients with neuro-developmental disorders in a large national database.

Methods: We used the IBM Explorys clinical database which includes over 74 million de-identiﬁed unique patients across 300 hospitals in the United States. Our patient cohort was identiﬁed using SNOMED and ICD codes. We identified all patients (age > 18) with neuro-developmental disorders who were diagnosed with either autism spectrum disorder (ASD), cerebral palsy (CP), or epilepsy. We investigated the prevalence of Crohn’s disease (CD) and ulcerative colitis (UC) in patients with NDD compared to patients with no NDD. Odds ratios with 95% conﬁdence intervals were calculated to evaluate the risk of IBD.

Results: We identified a total of 889,540 patients with NDD. Among them, 87,720 (9.86%) had ASD, 83,570 (9.39%) had CP and 758,370 (85.3%) had epilepsy. In this cohort, 12,730 (1.43%) and 6,700 (0.75%) developed either CD or UC, respectively compared to 0.57% in individuals without NDD, p< 0.0001 to all. There was a higher tendency for patients with both NDD and IBD to be female [OR: 1.06; 95% CI: 1.04 – 1.09] and Caucasian [OR: 1.45; 95% CI: 1.40 – 1.49]. Overall, patients with NDD had a significantly higher risk of CD [OR: 4.25; 95% CI: 4.17 – 4.33] and UC [OR: 2.60; 95% CI: 2.54 – 2.67] compared to patients without NDD (Figure 1). Patients with ASD [OR: 16.4; 95% CI: 15.9 – 16.9] and CP [OR: 17.5; 95% CI: 17.0 – 18.0] were associated with the highest risk of CD.

Discussion: In this large retrospective study, we found that patients with neurodevelopmental disorders had a significantly higher risk of IBD than the general population. Interestingly, CP and ASD patients were associated with a disproportionally high risk of CD. These findings may suggest a bi-directional relationship between neurological disorders and IBD.

Figure: Figure 1: Univariate analysis of IBD risk in neuro-developmental disorders. OR; odds ratio, CI; confidence interval

Variable	Patients with Neuro-developmental Disorders		Patients without Neuro-Developmental Disorders
Variable	With IBD	Without IBD	Patients without Neuro-Developmental Disorders
Age 18 - 64	10,990 (62.1%)	605,260 (69.4%)	47,344,760 (68.1%)
Age >65	6,650 (37.6%)	263,700 (30.2%)	21,023,950 (30.2%)
Female	10,800 (61.1%)	440,110 (50.5%)	38,048,260 (54.7%)
Caucasian	14,210 (80.3%)	584,130 (67.0%)	37,279,600 (53.6%)
Brain Neoplasm	2,860 (16.2%)	41,380 (4.7%)	305,330 (0.4%)
History of Meningitis	360 (2.0%)	10,970 (1.3%)	92,890 (0.1%)
History of Encephalitis	340 (1.9%)	10,120 (1.2%)	49,100 (0.1%)
History of CVA	5,260 (29.7%)	26,330 (3.0%)	205,620 (0.3%)

Table: Demographics of patients with neuro-developmental disorders and IBD. CVA; cerebrovascular accident

Disclosures:

Ahmed Eltelbany indicated no relevant financial relationships.

Khaled Alsabbagh Alchirazi indicated no relevant financial relationships.

Osama Hamid indicated no relevant financial relationships.

Abdul Mohammed indicated no relevant financial relationships.

Rama Nanah indicated no relevant financial relationships.

Miguel Regueiro: Abbvie – Advisory Committee/Board Member, Consultant. Abbvie – Grant/Research Support. ALFASIGMA, S.p.A. – Advisory Committee/Board Member. Allergan – Advisory Committee/Board Member. Amgen – Advisory Committee/Board Member. BMS – Grant/Research Support. Bristol Meyer Squibb – Advisory Committee/Board Member, Consultant. CC360 – Royalties. Celgene – Advisory Committee/Board Member. CME Outfitters – CME Companies. Cornerstones – CME Companies. Crohn’s and Colitis Foundation as Editor-in-Chief – Royalties. Genentech – Advisory Committee/Board Member. Genentech – Grant/Research Support. Gilead – Advisory Committee/Board Member. Gilead – Grant/Research Support. HMPGlobal – CME Companies. Imedex, GI Health Foundation (GiHF) – CME Companies. Janssen – Advisory Committee/Board Member, Consultant. Janssen – Grant/Research Support. Lilly – Grant/Research Support. MDEducation – CME Companies. Medscape – CME Companies. Miraca Labs – Advisory Committee/Board Member. MJH life sciences – CME Companies. Pfizer – Advisory Committee/Board Member, Consultant. Prometheus – Advisory Committee/Board Member. Remedy – CME Companies. Salix – Advisory Committee/Board Member. Seres – Advisory Committee/Board Member. Takeda – Advisory Committee/Board Member, Consultant. TARGET Pharma Solutions – Advisory Committee/Board Member. UCB – Grant/Research Support. WebMD – CME Companies. Wolters Kluwer Health as Author/Editor of UpToDate – Royalties.

Ahmed Eltelbany, MD, MPH¹, Khaled Alsabbagh Alchirazi, MD¹, Osama Hamid, MD, MRCPI¹, Abdul Mohammed, MD¹, Rama Nanah, MD¹, Miguel Regueiro, MD². A0385 - Patients With Neuro-Developmental Disorders Are Associated With a Higher Risk of Inflammatory Bowel Disease: A Nationwide Population-Based Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.