IBD in Hispanics and Caucasians: Disease characteristics and treatment

Abstract

Although inflammatory bowel disease (IBD) has been reported world-wide, most studies have focused on Caucasian patients. Little data exist on the characteristics of IBD in Hispanics living in the United States. Our aim was to evaluate Hispanic patients with IBD and compare their disease characteristics and management to Caucasian patients with IBD. We identified patients within the Harris County Hospital District, Houston TX with a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) recorded during 2000-2006. Medical records were reviewed to confirm the diagnosis and to abstract data on patient demographics, IBD characteristics (age of onset, disease location, disease phenotype), and treatment (surgery, medication, type of medication). A total of 69 Hispanic and 83 Caucasian patients with confirmed IBD were analyzed. Hispanics were diagnosed at a significantly older age than Caucasians (mean age 37.8 (SD 16) vs. 29.0 (SD 14) years; p<0.01). Among Hispanics with IBD, there was a greater proportion of UC (54%) than CD (46%), which differed from Caucasians who had a higher rate of CD (65%) than UC (35%); p<0.01. There were trends towards more frequent perianal disease in Hispanics with CD (24% vs. 15%) and more extensive colon involvement (63% vs. 38%) in Hispanics with UC compared to Caucasians. There were no significant differences in the frequency of radiologic and endoscopic examinations or in the frequency and type of prescribed IBD medication. A higher rate of bowel resection was seen for Caucasians compared to Hispanics overall (0.48 resections per patient compared to 0.22, p= 0.01). There was a trend towards a higher rate of bowel resection in Caucasians compared to Hispanics with CD (43% vs. 28%, p= 0.21), and more frequent bowel resection in Caucasians compared to Hispanics with UC (31% vs. 18%, p= 0.20). Hispanics with IBD are diagnosed at a significantly later age than Caucasians and they are more likely to have UC than CD. Hispanics with IBD also have a lower rate of bowel resection than Caucasians. It is unclear whether these findings reflect genetic, environmental differences, or healthcare access. However, no statistically significant differences were observed in the rates of diagnostic testing or medical management, between Caucasians and Hispanics.