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Objective: Inflammatory Bowel Disease has increased in Hispanics. This study estimates its prevalence in Puerto Rico for 2013 and compares it with prior reports., Methods: The database of commercial and government insurance claims of the Department of Health for 2013 was used. A case was defined as having at least two medical claims of outpatient services or one or more hospitalizations and emergency department visits with an ICD-9 code for Crohn's disease or ulcerative colitis. Cases with codes for both were classified as undetermined inflammatory bowel disease. Prevalence was calculated for inflammatory bowel disease, Crohn's disease, and ulcerative colitis overall and by age, sex, and health insurance., Results: 5,378 persons were classified as having inflammatory bowel disease, for an overall prevalence of 181.54/100,000. Of these, 2,154 had Crohn's disease and 2,689 had ulcerative colitis, with prevalences of 72.71 and 90.77/100,000 respectively. Crohn's disease was more prevalent in males and ulcerative colitis in females. Both types were more prevalent in the government insured population. 719 children had inflammatory bowel disease, for a prevalence of 89.8/100,000. Of these, 480 were classified as Crohn´s disease and 169 as ulcerative colitis. Prevalences for pediatric Crohn's disease and ulcerative colitis were 60.0 and 21.2/100,000 respectively., Conclusion: When compared with a report for 2005, the prevalence for inflammatory bowel disease in Puerto Rico for 2013 showed a 4-fold increase overall and a 3-fold increase in children. Inflammatory bowel disease was more prevalent in government-insured as opposed to commercially insured persons, in contrast with previous findings.

Objective: To review the experience with ileal pouch-anal anastomosis surgery for ulcerative colitis at the University Hospital., Background: As many as 40% of patients with ulcerative colitis (UC) and 75% with Crohn's disease (CD) require some surgery for their disease. The number of patients referred to our clinics for evaluation and management of Inflammatory Bowel Disease (IBD) has risen in the past seven years. A multidisciplinary IBD service has been created at the University Hospital for the care of these patients, leading to a dramatic increase in the number of surgeries performed for IBD. Over the past decade the ileal pouch-anal anastomosis (IPAA) has emerged as the procedure of choice in most patients with ulcerative colitis requiring total colectomy for management of their disease. Even though the procedure is associated with a considerable morbidity rate, it has become very popular since it avoids the need for a permanent stoma and presumably rids the patient of disease and subsequent cancer risk., Results: Twenty-five patients were identified as having IPAA for ulcerative colitis between 1993-2000. Indications for surgery were intractability and toxic megacolon. Complications were pouchitis in 11/25 (44%), anastomotic stricture in 6/25 (24%), small bowel obstruction in 4/25 (16%), and pouch failure in 2/25 (8%). Other complications included wound abscess in 1/25 (4%), and sexual dysfunction in 1/25 (4%) patients. There was no mortality; the patients' quality of life was rated as greatly improved in 14 of 17 patients interviewed (82.4%) and 16 of 17 said they would recommend the surgery to others (94.1%)., Conclusions: The results of IPAA surgery, morbidity, mortality, and patient satisfaction in our series were similar to other centers around the world.