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

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.