Risk Factors and Impact of Diagnostic Delay in Patients with Inflammatory Bowel Disease in Bangladesh

Background and Aims: A delay in the diagnosis of inflammatory bowel disease (IBD) is a risk of developing complications and surgery. This study was done to evaluate the factors and impact of diagnostic delay on IBD patients in Bangladesh. Methods: This cross-sectional study was carried out in the Department of Gastroenterology of a tertiary care center in Bangladesh. Diagnostic delay was defined as the period from symptom onset to diagnosis of IBD. Results: Of the total 112 IBD patients 50 (44.6%) had Crohn’s disease CD and 62 (55.4%) had ulcerative colitis (UC). Males (67.9%) were predominant in the study. The median diagnostic delay was longer for patients with CD compared with patients with UC (median 24 versus 12 months; P-value 0.025). Rectal bleeding as presenting feature and male gender were negatively and positively associated with the longer diagnostic delay of IBD respectively (P-value <0.05). Of the patients with CD 14 (28%) had a history of IBD-related surgery and 7 (14%) had a history of perianal fistula. The presence of intestinal strictures, surgery, and perianal fistula at the time of diagnosis was significantly associated with long diagnostic delay for CD. Conclusion: Absence of rectal bleeding as presenting symptoms and also the male gender were the significant factors related to the longer diagnostic delay of IBD in our study. Long diagnostic delay is associated with an increased rate of complications in IBD, especially in CD.