Survey of inflammatory bowel diseases in India

Abstract

Inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn's disease (CD), once thought to be uncommon, is now seen commonly in India. The Indian Society of Gastroenterology (ISG) Task Force on IBD decided to collate data on the clinical spectrum of IBD currently prevailing in India. An open call to members of ISG was given through publication of a proforma questionnaire in the Indian Journal of Gastroenterology and the web portal of ISG. The proforma contained questions related with demographic features, family history, risk factors, clinical manifestations and characteristics, course of disease, and pattern of treatment of IBD. Of 1,255 filled questionnaires received, 96 were rejected and 1,159 (92.3%) were analyzed. This comprised data on 745 (64.3%) patients with UC, 409 (35.3%) with CD, and 5 with indeterminate colitis. The median duration of illness was longer in patients with CD (48months) compared to those with UC (24months) (p = 0.002). More than one half of patients (UC 51.6%, CD 56.9%) had one or more extraintestinal symptoms. A definite family history of IBD was present in 2.9% (UC 2.3% and CD 4.6%; p = 0.12). The extent of disease in UC was pancolitis 42.8%, left-sided colitis 38.8%, and proctitis alone in 18.3%. The extent of disease involvement in CD was both small and large intestine in 39.6%, colon alone in 31.4% and small intestine alone in 28.9%. Stricturing and fistulizing disease were noted in 18.8% and 4.4% of patients with CD respectively. Chronic continuous and intermittent disease course were present in 35.5% and 47.2% of UC patients respectively, and in 23.1% and 68.8% of CD patients. Four percent of patients with UC had undergone colectomy, while 15.2% of patients with CD underwent surgical intervention. The present survey provides a reasonable picture of the demographic features and clinical manifestations of Indian patients with IBD, their risk factors, course of disease, and the treatment given to them.