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Self-screening questionnaire for perianal fistulizing disease in patients with Crohn’s disease

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Author(s)
O Seong KweonBen KangYoo Jin LeeEun Soo KimSung Kook KimHyun Seok LeeYun Jin ChungKyeong Ok KimByung Ik Jang
Keimyung Author(s)
Lee, Yoo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean J Intern Med
Issued Date
2024
Volume
39
Issue
3
Keyword
Perianal fistulizing Crohn’s diseasePerianal diseaseScreening tool
Abstract
Background/Aims:
A poor prognostic factor for Crohn’s disease (CD) includes perianal fistulizing disease, including perianal fistula and/or perianal abscess. Currently, a tool to assess perianal symptoms in patients with CD remains nonexistent. This study aimed to develop a perianal fistulizing disease self-screening questionnaire for patients with CD.

Methods:
This prospective pilot study was conducted at three tertiary referral centers between January 2019 and May 2020. We formulated questions on perianal symptoms, including tenesmus, anal discharge, bleeding, pain, and heat. A 4-point Likert scale was used to rate each question. Patients with CD completed a questionnaire and underwent pelvic magnetic resonance imaging (MRI).

Results:
Overall, 93 patients were enrolled, with 51 (54.8%) diagnosed with perianal fistulizing disease, as determined by pelvic MRI. The Spearman correlation findings demonstrated that anal pain (p = 0.450, p < 0.001) and anal discharge (p = 0.556, p < 0.001) were the symptoms that most significantly correlated with perianal disease. For anal pain and discharge, the area under the receiver operating characteristic curve of the scores was significantly higher than that of the combined score for all five symptoms (0.855 vs. 0.794, DeLong’s test p = 0.04). For the two symptoms combined, the sensitivity, specificity, and positive predictive and negative predictive values were 88.2, 73.8, 80.4, and 83.8%, respectively, with 81.7% accuracy for detecting perianal fistulizing disease.

Conclusions:
This study indicates that simple questions regarding anal pain and discharge can help accurately identify the presence of perianal fistulizing disease in patients with CD.
Keimyung Author(s)(Kor)
이유진
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2005-6648
Source
https://www.kjim.org/journal/view.php?number=170906
DOI
10.3904/kjim.2023.410
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45396
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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