cohort, at referral to the centre and during follow-up, and contributes to the burden of IBD in referral populations. Most patients were assessed for anemia regularly and with accurate anemia workup in patients prescribed intravenous iron therapy, yet the targeted management of moderate to severe anaemia was suboptimal. Mo1826 THE IMPACT OF TOTAL COLECTOMY ON THE COURSE OF EXTRAINTESTINAL MANIFESTATIONS IN SWISS IBD COHORT STUDY PATIENTS Rene Roth, Stephan R. Vavricka, Michael M. Scharl, Philipp Schreiner, Thomas Greuter, Jonas Zeitz, Ekaterina Safroneeva, Alain M. Schoepfer, Mamadou Pathe Barry, Gerhard Rogler, Luc Biedermann Background: Extraintestinal manifestations (EIM) are reported to occur in a highly variable frequency of between 6% and up to 47% of patient with IBD during the course of disease and may substantially contribute to the overall disease burden. Little is known on the impact of colectomy in UC or CD patients on the course of EIM, neither regarding pre-existing vs. de-novo EIM occurring after colectomy nor regarding potential differences between EIM typically known to follow a parallel vs. independent course of activity to disease activity of underlying IBD. Methods: Using data from the Swiss IBD Cohort Study (SIBDCS) we aimed to analyze the course of EIM in UC and CD patients undergoing colectomy during the prospective SIBDCS follow-up. Results: Amongst a total of 3620 IBD patients (53.6% CD, 42.8% UC, 3.6% IBD unclassified), 115 IBD patients (33 CD and 82 UC) underwent colectomy. One or more EIM had been present at any time antecedent to colectomy in 35.7% of these patients (27.3% and 39% in CD and UC patients, respectively). Within the 115 IBD patients undergoing colectomy any EIM was present only before colectomy in 21 patients (18.3% of all patients undergoing colectomy), i.e. entirely ceased thereafter in 51.2% of patients with any EIM prior to colectomy. After colectomy, overall 30 out of the 115 patients (26.1%) suffered from any EIM after colectomy. Out of these, two thirds (20 patients) already had any EIM prior to colectomy, while in one third (10 patients) occurrence of EIM represented a de-novo event after colectomy. Overall, amongst all patient with no EIM prior to undergoing colectomy 13.5% of patients developed a de-novo EIM after colectomy. The fraction of patients with complete cessation of EIM after colectomy was numerically higher in patients with UC vs. CD with 56.3% vs. 33.3% of patients with EIM prior to colectomy, respectively (51.2% in IBD patients overall). An overview over the frequency of EIM overall and individual EIM is provided in Figure 1. Conclusion: In IBD patients with undergoing colectomy, any EIM present prior to surgical intervention will persist in about half of patients. Although our results are based on a limited number of patients our findings indicate, that complete cessation of EIM after colectomy may be less common in CD than in UC patients. Absence of EIM prior to colectomy does not equal freedom from any EIM thereafter as up to one in seven IBD patients may develop de-novo EIM after colectomy. Number of patients with EIM in IBD patients is provided for EIM overall and individual EIM of joints, eyes, skin and liver. Green bars refer to EIM, which were present already prior to colectomy, with blue bars indicating those EIM persisting after colectomy and purple bar referring to de-novo occurrence of EIM after colectomy. Mo1827 INCREASING FREQUENCY IN THE DIAGNOSIS AND DIFFERENTIAL CLINICAL PATTERNS OF INFLAMMATORY BOWEL DISEASE IN LATIN AMERICA AND THE CARIBBEAN: A MULTICENTER COHORT STUDY (EPILATAM) Jesus K. Yamamoto-Furusho, Norma N. Parra-Holguin, Fabian Juliao, Guillermo R. Veitia, Esther A. Torres, Felipe Piñol-Jiménez, Socrates Bautista, Aleydi M. Frías-Santana, Keyla C. Villa, Guillermo Otoya, Beatriz Iade, EPILATAM STUDY GROUP Background: Inflammatory Bowel Disease (IBD) is currently recognized as a global health problem, since its incidence and prevalence have increased significantly worldwide in recent years. Studies from Latin America are only limited to report the incidence and prevalence in few cities, so our main objective was to report the frequency in the diagnosis and clinical characterization of IBD in Latin American and Caribbean regions. Methods: This is a multicenter cohort study from 8 countries of Latin American and Caribbean regions that included: Colombia, Cuba, Mexico, Peru, Puerto Rico, Dominican Republic, Uruguay and Venezuela during the period from August 2017 to October 2019. Two study groups were conducted by geographic region: Group 1 included the Caribbean such as Cuba, Puerto Rico and Dominican Republic and Group 2 was formed by Latin America countries like S-939 AGA Abstracts Colombia, Mexico, Peru and Venezuela. Statistical analysis was performed with the statistical program SPSS v.24. A p value <0.05 was considered as significant. Results: This study included a total of 4,216 IBD patients from 8 countries belonging to Latin America and Caribbean regions. There is an increased frequency in the diagnosis of IBD in the last two decades (2000-2019), being 7.5 times for UC and 12.5 times for CD as shown in figure 1. The CD was more frequent than UC in the following countries: Puerto Rico with 68.5%, Dominican Republic 56.3% and Peru with 53.1%, while in the rest of the countries the frequency of UC predominated, in Colombia by 79.2%, Venezuela in 78.4%, Cuba in 69.9% and Mexico in 75.8%. The Caribbean countries had a significantly higher frequency in the fistulizing phenotype in CD with 65.1% (P = 0.0001), steroid dependence in 11.51% (P= 0.002), steroid resistance in 28.5% (P = 0.0001) , thiopurine intolerance in 1.40% (P = 0.0002), extraintestinal manifestations in 55.91% (P = 0.0001), IBD surgeries in 32.10% (P = 0.0001) and family history of IBD reported a frequency of 15.60% (P = 0.0001). For Latin America, the frequency of pancolitis was more frequent in 48.21% (P=0001) in patients with UC. The factors associated with the use of biological therapy were: fistulizing phenotype in CD, steroid resistance, thiopurine intolerance, presence of extraintestinal manifestations and IBD related surgeries. Conclusions: This is the first large and multicenter cohort study performed in Latin America and the Caribbean that demonstrated an important increased of the IBD diagnosis in the last two decades as well as the differences in clinical and epidemiological characteristics between both regions. Increased in the frequency of IBD in Latin America and the Caribbean in the last two decades Mo1828 THE EPIDEMIOLOGY OF INFLAMMATORY BOWEL DISEASES AMONG IMMIGRANTS TO DENMARK: A POPULATION-BASED COHORT STUDY Manasi Agrawal, Sarita Shrestha, Giulia Corn, Nete Munk Nielsen, Morten Frisch, Jean Frederic Colombel, Tine Jess Background The incidence of inflammatory bowel diseases (IBD) among immigrants and in countries with historically low IBD risk is rising, implicating environmental risk factors in IBD pathogenesis. The purpose of our study was to determine the incidence rates of Crohn’s disease (CD) and ulcerative colitis (UC), among immigrants to Denmark, a high-IBD-inci- dence country, according to country of birth and age at immigration, in comparison with the corresponding incidence rates in the Danish host population. Methods Using the Danish Civil Registration System, we identified all residents in Denmark with known country of birth between January 1977 and December 2018. First-generation immigrantswere persons who, along with parents, were born outside Denmark; second-generation immigrants were Danish-born persons whose parents were born outside Denmark. We recorded immigrants’ (or parents’) country of birth, age at immigration and duration of stay in Denmark. Study participants were followed for CD and UC diagnosis in the Danish National Patient Registry. Incidence rate ratios (IRRs) according to immigration status were estimated using log-linear Poisson regression analysis, and stratified by IBD prevalence in country of birth (low, intermediate and high), and among first-generation immigrants, by age at immigration and duration of stay in Denmark. Results In this cohort of 9,038,025 subjects, among 1,295,518 first- and 208,826 second-generation immigrants eligible for inclusion, 4,805 first- and 898 second-generation immigrants were diagnosed with CD or UC. The risk of IBD among first- generation immigrants reflected risk in country of birth (low, intermediate or high, table 1), and increased with >20 years stay in Denmark (table 2). Among second-generation immigrants, the risk of CD and UC was comparable to that in Danish natives (table 1). Younger age at immigration did not impact IBD risk. Conclusion In this population-based study, the risk of IBD among first-generation immigrants reflected that in their country of birth, and increased with >20 years stay in Denmark. Among second-generation immigrants, the risk was comparable to native Danes. These findings underscore the role of environmental risk factors in the etiology of IBD. Further studies to determine risk factors for IBD among immigrants to Denmark are ongoing. AGA Abstracts