S956 A Meta-Analysis of Colonic Involvement in Ulcerative Colitis Among Asian Countries

Abstract

Introduction: Ulcerative Colitis (UC) is a chronic inflammatory non-fatal disease usually found in the large intestine and rectum. Over the years the incidence and prevalence of UC has been lower in Asia when compared to the Western World. However, new studies in Asia are showing an increase in the incidence of UC over the past 2 decades. Here we aim to assess the incidence and manifestations of Ulcerative Colitis across multiple countries in Asia. Methods: An extensive meta-analysis on Ulcerative colitis patients was performed comparing articles from different parts of Asia, and R software was used 2 compile the data. In addition, the patient's data regarding colonic involvement was reviewed. Patient’s data was then matched using propensity score matching in the R software. Results: Incidence of rectal involvement was high among the Chinese and Indian population (30.30% China vs. 5.56% Hong Kong vs. 2.53% Singapore vs.19.80% Korea vs. 31.82% India, p:0.023 95%CI). Left-sided ulcerated colitis was predominant among the Chinese population (38.28% China vs. 5.26% Hong Kong vs. 0.93% Singapore vs. 13.80% Korea vs. 10.82% India, p:0.033 95%CI). Extensive colonic manifestation involving most of the colon was seen in the Indian population compared to other nationalities (10.01% China vs. 9.09% Hong Kong vs. 7.27 % Singapore vs. 20.80% Korea vs. 44.10 % India, p < 0.01 95%CI). Conclusion: There are a multitude of factors that may be contributing to the rise of both the incidence and prevalence of UC in Asian Countries. These factors include westernization of lifestyle, changes in diet, increased use of modern medicine from the traditional homeopathic modalities, and/or industrialization of society. As you can see from our study, the incidence, prevalence and manifestations even within Asia vary among the countries. A study conducted in 2013 which compared Singapore, Malaysia, and India found that Indians not only had a higher prevalence of UC but also had more extensive disease. In our study, we found that rectal involvement was highest among Chinese and Indians. However, extensive colonic involvement was seen at a significantly higher rate in Indians compared to the rest.