scholarly journals Evidence of On-Going Disparate Levels of Care for South Asian Patients with Inflammatory Bowel Disease in the United Kingdom during the Quinquennium 2015–2019

2022 ◽  
Vol 4 (1) ◽  
pp. 8-14
Author(s):  
Affifa Farrukh ◽  
John F. Mayberry
Keyword(s):  
Inflammatory Bowel Disease ◽  
South Asian ◽  
Bowel Disease ◽  
The South ◽  
Asian Community ◽  
Levels Of Care ◽  
Asian Patients ◽  
South Asian Community ◽  
Inflammatory Bowel ◽  
The Uk

Over the last decade, there have been a number of studies which have documented disparate levels of care in the management of inflammatory bowel disease amongst various minority communities in the UK. Similar findings had previously been described in the USA, where access to biologics has been an issue. In this study, data on admissions to hospital of South Asian and White British patients with inflammatory bowel disease between 2015 and 2019 were collected from 12 National Health Service (NHS) trusts in England, three Health Boards in Wales and two Scottish health organizations using Freedom of Information requests. The analyses of data were based on the assumption that inflammatory bowel disease (IBD) has the same prevalence in the South Asian community and the White British community in the UK. Comparisons were made between the proportion of hospitalised patients who were South Asian and the proportion who were White British in the local community using a z statistic. In Leicester, Bradford, Croydon and Lothian, the proportion of patients from the South Asian community admitted to hospital was significantly greater than the proportion from the local White British community, which is consistent with the greater frequency and severity of the disease in the South Asian community in the UK. However, in Coventry, Wolverhampton, Walsall, Acute Pennine Trust in the north-west of England, Barking, Havering and Redbridge and Glasgow, South Asian patients were significantly under-represented, indicating significant issues with access to hospital-based healthcare for inflammatory bowel disease. This study provides evidence of on-going evidence of disparate levels of care for patients from a South Asian background, with inflammatory bowel disease being underserved by a number of NHS Trusts, Health Boards and comparable organisations. When there is on-going failure to achieve the objectives of the NHS of achieving equality in the delivery of care, it is critical to introduce effective policies which will alter the in-built inertia to change within such organisations.

M1129 Does the Clinical Phenotype of Inflammatory Bowel Disease Differ Between Caucasian and South Asian Patients Living in the UK?

2009 ◽  
Vol 136 (5) ◽  
pp. A-356
Author(s):  
David G. Walker ◽  
Horace R. Williams ◽  
Shamima Padaruth ◽  
Andrew N. Milestone ◽  
Jayantha Arnold ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
South Asian ◽  
Bowel Disease ◽  
Clinical Phenotype ◽  
Asian Patients ◽  
Inflammatory Bowel ◽  
The Uk

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

2007 ◽  
Vol 102 (5) ◽  
pp. 1077-1083 ◽  
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

scholarly journals P612 Dietary practices and beliefs of British South Asians with inflammatory bowel disease: A prospective UK study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S510-S510
Author(s):  
B Crooks ◽  
J McLaughlin ◽  
J K Limdi
Keyword(s):  
Inflammatory Bowel Disease ◽  
South Asian ◽  
Bowel Disease ◽  
Red Meat ◽  
Dietary Advice ◽  
Dietary Practices ◽  
Milk Products ◽  
Immigrant Populations ◽  
Inflammatory Bowel ◽  
The Uk

Abstract Background The increasing incidence of inflammatory bowel disease (IBD) in newly industrialised countries and immigrant populations appears to outpace that which genetic influences alone could instigate. Environmental factors, in particular, the western diet, are therefore implicated in its aetiopathogenesis. Limited data exist on the dietary practices of the migrant South Asian population with IBD. We aim to describe the dietary practices of British South Asian IBD patients and information resources utilised to guide these beliefs. Methods A prospective, cross-sectional, questionnaire-based study is being conducted across hospitals in the UK. Two-hundred South Asian patients with IBD are being recruited to complete a questionnaire regarding demographics and dietary practices. Results Data from 118 patients are available to date. Mean patient age is 43 years (51% female). Sixty-five per cent have ulcerative colitis (UC) and 33% Crohn’s disease (CD). Fifty-one per cent are of Indian ethnicity, 37% Pakistani and 10% Bangladeshi. Forty-nine per cent of patients were born in the UK to parents who were born outside of the UK and 51% of patients were born outside the UK. Mean disease duration is 10.5 years. Forty-six per cent considered diet to be an initiating factor in their IBD, based on their own experience (85%) as well as information from internet resources (31%) and other patients with IBD (19%). Fifty-nine per cent of patients felt that diet had triggered a relapse of their disease. Most commonly reported foods were spicy (69%) and fatty foods (47%), milk products (44%) and red meat (37%). Eighty-six per cent of patients avoided certain foods in an attempt to prevent an IBD ‘flare’. Most frequently avoided foods were spicy foods (76%), fatty foods (69%), red meat (60%), coffee (55%), carbonated drinks (54%) and milk products (53%). One in four patients had tried a specific exclusionary diet, with 13% having tried a gluten-free diet in the absence of coeliac disease, to manage their symptoms. Just over a half of patients reported being able to find specific dietary advice for IBD, most commonly via the internet. Over half of patients avoided eating the same meal as their family or eating out to prevent relapse of their IBD. 1 in 3 consumed certain foodstuffs or nutritional supplements to prevent a relapse of IBD, most commonly turmeric in 25% of these patients. Conclusion Dietary restriction may be highly prevalent amongst the British South Asian IBD community with a high proportion reporting diet as an initiating factor and trigger for disease flares. Studies on immigrant populations may hold valuable clues regarding the influence of migration, environmental influences and drift from traditional cultural practices on IBD aetiopathogenesis and related symptoms. A larger dataset will be presented at conference proceedings.

South Asian Patients With Inflammatory Bowel Disease in the United States Demonstrate More Fistulizing and Perianal Crohn Phenotype

2020 ◽  
Vol 26 (12) ◽  
pp. 1933-1942 ◽  
Author(s):  
Sushrut Jangi ◽  
Alex Ruan ◽  
Joshua Korzenik ◽  
Punyanganie de Silva
Keyword(s):  
United States ◽  
Inflammatory Bowel Disease ◽  
South Asian ◽  
Bowel Disease ◽  
South Asians ◽  
The United States ◽  
Phenotypic Characteristics ◽  
Asian Patients ◽  
Inflammatory Bowel ◽  
White Patients

Abstract Background South Asians have recently been identified as having a rapidly rising incidence and prevalence of inflammatory bowel disease (IBD) throughout the world. However, longitudinal phenotypic studies of South Asians living in the United States remain scarce. Methods We retrospectively studied 171 South Asian patients with IBD treated at 2 US tertiary centers who presented between 2000 and 2016. South Asian IBD patients were randomly matched in a 1:2 ratio with sex and IBD subtype–matched (ulcerative colitis [UC] vs Crohn disease [CD]) white control patients (n = 342). Demographic and phenotypic characteristics were evaluated and compared between the 2 groups. Odds ratios (OR), logistic regression, and survival analysis were performed using R studio and STATA. Results 81 South Asian patients and 162 white patients had CD, and 90 South Asians and 180 white patients had UC. Among the CD group, South Asian patients were diagnosed at a median older age (age 28) than white patients (21 years; P < 0.003). Fistulizing disease (24.1% vs 8.6%; P < 0.002), perianal disease (20.3% vs 2.5%; P < 0.005), and presentation of rectal pain (16.2% vs 2.9%; P < 0.001) were more common among South Asian patients with CD than among white patients. After adjusting for covariates, South Asian patients with CD were less likely to be placed on thiopurines (OR = 0.36; P < 0.007) or to receive more than 1 biologic (OR = 0.42; P < 0.040). South Asian patients with UC were less likely to have proctitis (10% vs 22.2%; P < 0.022) and more likely to have primary sclerosing cholangitis (n = 7 vs n = 2; P < 0.007). South Asian patients born in the United States or those who had migrated before age 5 were younger at the age of IBD diagnosis (age 18.9 vs 32.4; P < 0.0005). Conclusion We found unique demographic and phenotypic characteristics among South Asian patients, including more penetrating disease in those with CD and less proctitis among those with UC, along with altered medication use patterns. Distinct environmental exposures and a potentially unique genetic profile of South Asian patients may confer this variable phenotypic expression, influencing management of this increasingly at-risk population.

scholarly journals Inflammatory bowel disease and the South Asian diaspora

JGH Open ◽  
2019 ◽  
Vol 3 (5) ◽  
pp. 358-360
Author(s):  
Affifa Farrukh ◽  
John Francis Mayberry
Keyword(s):  
Inflammatory Bowel Disease ◽  
South Asian ◽  
Bowel Disease ◽  
South Asian Diaspora ◽  
The South ◽  
Asian Diaspora ◽  
Inflammatory Bowel

Comparison of Disease Phenotypes and Clinical Characteristics Among South Asian and White Patients with Inflammatory Bowel Disease at a Tertiary Referral Center

2020 ◽  
Vol 26 (12) ◽  
pp. 1869-1877
Author(s):  
Vimal Bodiwala ◽  
Timothy Marshall ◽  
Kiron M Das ◽  
Steven R Brant ◽  
Darren N Seril
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
South Asian ◽  
Bowel Disease ◽  
South Asians ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Asian Patients ◽  
Inflammatory Bowel ◽  
White Patients

Abstract Background The prevalence and clinical features of inflammatory bowel disease (IBD) vary among different racial and ethnic groups. The aim of this study was to compare the clinical and phenotypic features of Crohn’s disease (CD) and ulcerative colitis (UC) in South Asian patients living in the United States with those of a white cohort. Methods The demographic, clinical, and phenotypic characteristics of 73 South Asian patients (31 CD and 42 UC) who presented initially to our tertiary referral center from 2012 to 2016 and had subsequent follow-up were retrospectively compared with those of 408 consecutive white patients (245 CD and 163 UC). Results South Asian IBD patients were significantly more likely to have UC (58.0% vs 40.0%; P = 0.005) than white patients. South Asians with CD were less likely to have a family history of IBD (9.7% vs 26.9%; P = 0.037) and required fewer CD-related surgeries (22.5% vs 46.1; P = 0.012). South Asians were also less likely to be active or former smokers in both the CD (P = 0.004) and UC (P = 0.020) groups. South Asians with UC had a higher incidence of Clostridium difficile infection compared with white patients (19.0% vs 8.6%; P = 0.050). Conclusions A cohort of South Asian patients with IBD were more likely to have UC and had differing family and tobacco risk factors, requirements for surgery, and Clostridium difficile infection rates as compared with white patients.

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