Introduction: As a chronic disease, IBD patients receive much of their health care in primary care. An Australian survey found 37% of General Practitioners (GPs) were ‘ uncomfortable’ with managing IBD. We assessed the knowledge and attitudes of GPs caring for IBD patients in New Zealand. Methods: An online survey was developed covering GP attitudes to care (5-point Likert scale or didactic response format), and knowledge (multiple choice questions about disease, investigations and treatment). The questionnaire was circulated via 2 PHOs (Procare and Comprehensive Care) and the Royal College of GP newsletter. GPs returning the questionnaire received feedback with referenced answers to the questions. All responses were anonymized. Results: 43 responses. 37 practices <35, 000. Median 50 patients per practice. Mean 2 consultations/month. Knowledge; Disease: 4 questions were scored correctly by <66% of GPs; extraintestinal organ involvement 63%, constituents of disease activity indices 19% & 14%, causes of death 5%. Investigations & Treatment: 9/15 scored correctly by <66%; stool culture during flare 51%, commencement or continuation of 5-ASA therapy 7%, 58% & 51%, steroid effectiveness & treatment duration during acute flares 58% & 28%, immunomodulator examples and side-effects 23% & 51%, immunosuppressive risk with biological vs steroids 12%...

Background: According to the significance of extraintestinal symptoms in inflammatory bowel disease (IBD) patients and their connection with obesity, we aimed to investigate the prevalence of fatty liver in IBD patients of Sayyad Shirazi Hospital in Gorgan, Iran, in relation to obesity, anthropometric indicators and body image in these patients. Methods: Forty patients with IBD were recruited from all registered patients at the Golestan Research Center of Gastroenterology and Hepatology, following the specified inclusion and exclusion criteria. After obtaining written informed consent and filling in the questionnaire, the demographic and anthropometric indicators, and variables related to the disease were measured. The liver sonography was performed on all patients and graded by an expert radiologist. Data were analyzed using SPSS Version 16.0 statistical software at the significance level of 0.05. Results: We showed no significant difference between the distribution of demographic and anthropometric indicators in different groups of IBD patients. However, we demonstrated that the inappropriate values of HDL (0.004) and high values of LDL (0.015) were associated with fatty liver in IBD patients. Our findings also showed that NAFLD was significantly associated with overweight and obesity among IBD patients (P = 0.003). Conclusion: Our findings showed the epidemiological burden of NAFLD in IBD patients. Since fatty liver was associated with obesity, it is recommended that IBD patients be screened for risk factors associated with NAFLD to prevent liver disease.

Introduction: High standards of inpatient care are associated with improved clinical outcomes for IBD patients. IBD standards have been recommended internationally (e. g UK, Australia). We aimed to assess the current care of IBD inpatients, and compare to a previous audit in 2013. Methods: We identified all patients admitted to Christchurch hospital over a 6-month period from March to August 2019 with an IBD flare using hospital discharge codes. Data were extracted from clinical records and analysed descriptively. Results: Seventy-two IBD flares (32 male and 40 female; median age 44 [17-81] years) were identified, including 58 with Crohn’ s Disease (CD) and 14 with Ulcerative Colitis (UC). Forty-one (57%) were managed under Gastroenterology, thirty-one (43%) under General Surgery. Contact with the IBD helpline resulted in three admissions (4%). Seventy-one (99%) had smoking status documented, and ten (14%) were current smokers. Compared to the 2013 audit, significantly more patients with luminal symptoms had abdominal imaging (89% vs 45%; p<. 01). More patients received venous thromboembolism (VTE) prophylaxis (65% vs 48%; p=0. 052). Stool cultures and Clostridium difficile toxin were analysed in 48% compared to 39%, p=. 38. Of the forty-two (58%) discharged on oral prednisone, thirty-nine (93%) had a taper plan. No patients received bone protection. There were 43 complications in the following six-months among CD patients, and seven among UC patients. On average, time to clinic was 6. 3 weeks following discharge. There were five UC and forty-one CD readmissions in the following 11 months. Conclusions: Some IBD standards are being met or have improved, such as smoking status, abdominal imaging, follow up and VTE prophylaxis. Other standards could be improved; such as stool sampling and bone protection. These results will be used to drive improvements to patient care, through presentation at departmental meetings and formation of clinical protocols. Standards will be re-audited in the future.