Inflammatory Bowel Disease in Afro-Caribbeans: Does It Differ from Other Ethnic Groups?

Abstract

Purpose: Recent studies in inflammatory bowel disease (IBD) have found phenotypic differences among ethnic groups. Limited data have been published about IBD patients of Afro-Caribbean (AC) origin. This study compares Afro-Caribbean IBD patients with three other ethnic groups. Methods: Retrospective study of 73 AC IBD patients, first and second generation, followed in the GI clinic. Data were compiled based on sex, diagnosis, age at onset/diagnosis, family history of IBD, disease distribution and pattern, and extra-intestinal manifestations. Results were compared to those of the large North American Cohort Study of IBD patients, which included African Americans (AA), Whites and Hispanics. Data on Crohn's disease (CD) and ulcerative colitis (UC) distribution, pattern, and extent were extracted using the same criteria described by the large North American Cohort study. Results: Differences were noted between AC patients and White, AA and Hispanic patients in regard to diagnosis, age at onset/diagnosis and family history of IBD (table). AC have significantly less ileo-colonic CD compared with Hispanics and significantly more CD colitis compared with the other groups. No upper gastrointestinal involvement was seen in AC; this significantly differs from Whites and AA. No significant difference was found in CD pattern or UC disease extent among AC and the other groups.Table. IBD: Phenotype in AC Compare with other Ethnic Groups from The Large North American Cohort StudyConclusion: This is the largest series of AC IBD patients described in the literature. We found phenotypic differences among AC with IBD compared with other ethnic groups. The differences are likely related to genetic and environmental factors. A better understanding of these differences may influence patient management and disease prognosis.