Distribution of Inflammatory Bowel Disease (IBD) among African Americans (AA) and Hispanics (HIS) at an Inner City Hospital

Abstract

Purpose: General demographic features of IBD have been well established in the caucasian population but relatively little is known about minorities, which may have implications in tailoring treatment modalities. Methods: We reviewed the charts of IBD patients followed in our clinic and identified 26 active Ulcerative Colitis (UC) patients, 13 were AA and 8 HIS.17 patients with active Crohn's Disease (CD) were found, 10 AA and 7 HIS. We recorded BMI, mean age at diagnosis, smoking history, family history along with endoscopic findings on initial presentation in each IBD group and ethnic class. Results: In the UC group, mean age at diagnosis was 43.5 years for AA and 40 years for HIS. Mean BMI for AA was 32.3 and 29.8 for HIS. AA group had 2 (15.5%) positive family history whereas none of the patients in HIS had an affected family member. 5 (38.5%) of AA were active smokers (> 1 stick/day) whereas 1 (12.5%) among HIS were smokers. On initial endoscopy 8 (61%) of the AA with UC had pancolitis while 5 (39%) had left sided colitis. While in Hispanics 7 (58%) had pancolitis, 2 (16%) had left sided colitis, and 3 (24%) had proctitis. AA with CD had mean age of 24.4 yrs and HIS had a mean age of 32.3 yrs at diagnosis. Mean BMI for AA was recorded at 27.7 and 32.3 for HIS. In CD 2 (20%) of AA had a positive family history of IBD as compared to none in HIS group. Two (20%) of AA were smokers whereas no one among HIS group had active smoking in the CD group. On initial presentation 6 (60%) AA had pancolitis while 2 (20%) had sigmoiditis and 2 (20%) had ileitis. Among Hispanics with CD 4 (57%) had pancolitis and 3 (43%) had ileitis as initial presentation.Figure: [1657]Conclusion: In our cohort, both AAs and HIS with UC presented at an age older than the 15-30 first peak and younger than the over 65 second peak usually reported for IBD (43 years and 40 years respectively) All of our patients were overweight. However, in contradistinction to reports of higher BMIs in CD patients our AA patients with CD had the lowest BMI. Our cohort suggests that AAs and HIS with IBD have a different presentation than their Caucasian counterparts. Further study is warranted.