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Post-inflammatory polyps burden as a prognostic marker of disease-outcome in patients with inflammatory bowel disease

Ellul, P; Schembri, J; Baldacchino, Vella A; Molnar, T; Resal, T; Allocca, M A; Furfaro, F; Buono, Dal; Theodoropoulou, A; Fragaki, M; Tsoukali, E; Mantzaris, G J; Phillips, F; Radford, S; Moran, G; Gonzalez, H A; Sebastian, S; Fousekis, F; Christodoulou, D; Snir, Y; Lerner, Z; Yanai, H; Michalopoulos, G; Tua, J; Camilleri, L; Papamichael, K; Karmiris, K; Katsanos, K


P Ellul

J Schembri

Vella A Baldacchino

T Molnar

T Resal

M A Allocca

F Furfaro

Dal Buono

A Theodoropoulou

M Fragaki

E Tsoukali

G J Mantzaris

F Phillips

S Radford

Clinical Associate Professor

H A Gonzalez

S Sebastian

F Fousekis

D Christodoulou

Y Snir

Z Lerner

H Yanai

G Michalopoulos

J Tua

L Camilleri

K Papamichael

K Karmiris

K Katsanos



Introduction and Aim
Post-inflammatory polyps (PIPs) are considered as indicators of previous episodes of severe inflammation and mucosal ulceration. Inflammatory bowel disease (IBD), namely Crohn’s disease (CD) and ulcerative colitis (UC), exhibit a perpetuating, relapsing, and remitting pattern and PIPs is a frequent sequela of chronicity. The aim of this study was to determine whether a high PIPs burden is associated with a more severe disease course in patients with IBD.

This was a multinational, multicentre, retrospective study. IBD patients previously diagnosed with PIPs were retrieved from the endoscopic database of each centre. PIPs burden was evaluated and associated with demographic and clinical data as well as factors indicating a more unfavorable disease course.

A total of 504 IBD patients with PIPs were recruited (male: 61.9%). The mean age at IBD diagnosis was 36.9 (±16.8) years. Most patients (74.8%) were diagnosed with UC. A high PIPs burden was present in 53.4% of patients. On multivariable Cox regression analysis, high PIPs burden was independently associated with treatment escalation (HR 1.35, 95% CI 1.04-1.75; P=0.024), hospitalization (HR 1.90; 95% CI 1.24 – 2.90; P=0.003), need for surgery (HR 2.28; 95% CI 1.17-4.44, P=0.02) and younger age at diagnosis (HR 0.99, 95% CI 0.98–0,99; p=0.003).

PIPs burden was associated with a more severe outcome. Future prospective studies should focus on the characterisation of PIPs burden as to further risk stratify this patient cohort.


Ellul, P., Schembri, J., Baldacchino, V. A., Molnar, T., Resal, T., Allocca, M. A., …Katsanos, K. (2022). Post-inflammatory polyps burden as a prognostic marker of disease-outcome in patients with inflammatory bowel disease. Journal of Crohn's and Colitis,

Journal Article Type Article
Acceptance Date Nov 9, 2022
Online Publication Date Nov 2, 2022
Publication Date Nov 2, 2022
Deposit Date Nov 9, 2022
Publicly Available Date Nov 3, 2023
Journal Journal of Crohn's and Colitis
Print ISSN 1873-9946
Electronic ISSN 1876-4479
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Keywords Gastroenterology; General Medicine
Public URL
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