Changing Incidence of Inflammatory Bowel Disease: Environmental Influences and Lessons Learnt from the South Asian Population

Abstract Background and Aims It is widely acknowledged that the incidence of inflammatory bowel disease [IBD] is rising within South Asian populations, yet research into the experiences of this group of patients is rare. In this study the lived experiences of UK South Asian adults with IBD, including support from gastroenterology services, was investigated. Methods A sample of 33 patients representing the diversity of the UK South Asian population were recruited through five gastroenterology clinics in England. In-depth semi-structured interviews were conducted, audio-recorded, transcribed and analysed using the Framework approach. Results Although many experiences align with those of the general IBD population, participants believed that South Asian cultures and/or religions can lead to additional challenges. These are linked to: family and friends’ understanding of IBD; self and family attributions regarding IBD; stigma surrounding ill health; the taboo of bowel symptoms; managing ‘spicy food’; beliefs about food and ill health; roles within the family; living with extended family; the use of complementary and alternative therapies; and visits to family overseas. Religious faith helped many to cope with having IBD, but symptoms could hamper their ability to practise faith. Gastroenterology services were viewed positively, but unmet needs were identified, some of which were culturally specific. Conclusion Gastroenterology services have an important role to play in helping patients to overcome the challenges they encounter in their everyday life, both by providing individual patients with culturally appropriate care and advice, and via interventions to increase awareness and understanding of IBD within wider South Asian communities.

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Mo1356 Inflammatory Bowel Disease in the Pediatric South Asian Population of British Columbia, Canada: A Distinct and Severe Phenotype

Gastroenterology ◽

10.1016/s0016-5085(13)62389-6 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-645-S-646

Author(s):

Matthew W. Carroll ◽

Hira S. Gill ◽

Jonathan Simkin ◽

Lee-Ann M. Carroll ◽

Vered Pinsk ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

British Columbia ◽

South Asian ◽

Bowel Disease ◽

Asian Population ◽

Severe Phenotype ◽

South Asian Population ◽

Inflammatory Bowel

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Environmental Changes and the Onset of Inflammatory Bowel Disease (IBD) in the Migrant South Asian Population

The American Journal of Gastroenterology ◽

10.14309/00000434-201210001-01581 ◽

2012 ◽

Vol 107 ◽

pp. S638

Author(s):

Michelle Nazareth ◽

Susan Lynch ◽

Jordan Mar ◽

Uma Mahadevan

Keyword(s):

Inflammatory Bowel Disease ◽

South Asian ◽

Bowel Disease ◽

Environmental Changes ◽

Asian Population ◽

South Asian Population ◽

Inflammatory Bowel

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PTH-107 Knowledge of South Asian Population in Inflammatory Bowel Disease: Ccknow- How much do they Know?

Gut ◽

10.1136/gutjnl-2013-304907.594 ◽

2013 ◽

Vol 62 (Suppl 1) ◽

pp. A254.2-A255

Author(s):

S Soteriadou ◽

S Hickman ◽

J K Limdi

Keyword(s):

Inflammatory Bowel Disease ◽

South Asian ◽

Bowel Disease ◽

Asian Population ◽

South Asian Population ◽

Inflammatory Bowel

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Inflammatory Bowel Disease in the South Asian Pediatric Population of British Columbia

The American Journal of Gastroenterology ◽

10.1111/j.1572-0241.2007.01124.x ◽

2007 ◽

Vol 102 (5) ◽

pp. 1077-1083 ◽

Cited By ~ 103

Author(s):

Vared Pinsk ◽

Daniel A. Lemberg ◽

Karan Grewal ◽

Collin C. Barker ◽

Richard A. Schreiber ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

British Columbia ◽

South Asian ◽

Bowel Disease ◽

Pediatric Population ◽

The South ◽

Inflammatory Bowel

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Ethnic Variation in the Annual Rates of Adult Inflammatory Bowel Disease in Hospitalized Patients in Vancouver, British Columbia

Canadian Journal of Gastroenterology ◽

10.1155/2011/640920 ◽

2011 ◽

Vol 25 (2) ◽

pp. 73-77 ◽

Cited By ~ 14

Author(s):

Birinder K Mangat ◽

Chad Evaschesen ◽

Tim Lee ◽

Eric M Yoshida ◽

Baljinder Salh

Keyword(s):

Inflammatory Bowel Disease ◽

British Columbia ◽

South Asian ◽

Bowel Disease ◽

South Asians ◽

Adult Population ◽

Asian Population ◽

Annual Rate ◽

Inflammatory Bowel ◽

Extent Of Disease

BACKGROUND: There is currently little available information regarding the impact of ethnicity on the clinical features of inflammatory bowel disease (IBD). Migrating populations and changing demographics in Vancouver, British Columbia (BC) provide a unique opportunity to examine the role of ethnicity in the prevalence, expression and complications of IBD.OBJECTIVES: To determine the demographics of IBD and its subtypes leading to hospitalization in the adult population of BC.METHODS: A one-year retrospective study was performed for all patients who presented acutely with IBD to Vancouver General Hospital from January 1, 2006 to December 31, 2006. Data regarding sex, age, ethnicity, IBD type and extent of disease, complications and management strategies were collected. Clinical data were confirmed by pathology and radiology reports.RESULTS: There were 186 cases of IBD comprising Crohn’s disease (CD) 56%, ulcerative colitis (UC) 43% and indeterminate colitis (1%) 1%. The annual rate of IBD cases warranting hospitalization in Caucasians was 12.9 per 100,000 persons (7.9 per 100,000 persons for CD and 5.0 per 100,000 persons for UC). This was in contrast to the annual rate of IBD in South Asians at 7.7 per 100,000 persons (1.0 per 100,000 persons for CD and 6.8 per 100,000 persons for UC) and in Pacific Asians at 2.1 per 100,000 persons (1.3 per 100,000 persons for CD, 0.8 per 100,000 persons for UC). The male to female ratio was higher in South Asians and Pacific Asians than in Caucasians. The extent of disease was significantly different across racial groups, as was the rate of complications.CONCLUSIONS: These early results suggest that there are ethnic disparities in the annual rates of IBD warranting hospitalization in the adult population of BC. There was a significantly higher rate of CD in the Caucasian population than in South Asian and Pacific Asian populations. The South Asian population had a higher rate of UC, with an increased rate of complications and male predominance. Interestingly, the rate of CD and UC was lowest in the Pacific Asian population. These racial differences – which were statistically significant – suggest a role for ethnodiversity and environmental changes in the prevalence of IBD in Vancouver.

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