Prevalence of inflammatory bowel disease (IBD) has increased to more than 5 per cent compared to 0.1 per cent in 2006, new Telangana-based research published in The Lancet Regional Health-Southeast Asia journal said.
IBD accounted for more than 5 per cent of patients presenting lower gastrointestinal symptoms such as abdominal chronic pain, bowel habit changes and chronic diarrhoea, the study conducted by the IBD Center of the Asian Institute of Gastroenterology (AIG), Hyderabad, found.
The figure of 5 per cent remained unchanged between urban and rural populations, the researchers said, after evaluating nearly 31,000 patients displaying lower gastrointestinal (GI) symptoms from March, 2020 to May, 2022.
A previous rural survey conducted by the same institute in 2006 estimated IBD prevalence at 0.1 per cent, the study said.
Urbanisation could be a likely cause behind the trend, say the researchers, citing Asian countries like Japan and Korea which have reported a rising prevalence, and both of which experienced rapid industrialisation after World War II.
The last two decades have seen an increasing incidence and prevalence of IBD in the Asia-Pacific region and that India appeared to be in an accelerated industrialisation phase, with a rapidly increasing IBD incidence, they said in the study.
If the trend continued, then the number of affected could likely exceed those in the West in the next decade, and this could have “significant implications for healthcare policy and expenditure in the region,” they wrote in the study.
For the study, patients attending urban out-patient clinics or specially conducted mobile rural health camps (in the villages of Ranga Reddy, Sangareddy and Vikarabad districts of Telangana) were assessed.
Of these, 67 per cent were males and 21 per cent from a rural setting and the median age of the sample was 44 years.
Overall, 5.4 per cent were diagnosed with IBD and included cases of both ulcerative colitis, which is a chronic inflammatory disease of the large intestine and rectum, and Crohn’s disease, which is a chronic inflammation of the ileum in the small intestine.
Infectious colitis (inflammation in the colon) was the diagnosis in 4.6 per cent of the study sample, while colorectal cancer and intestinal tuberculosis was the diagnosis in 1.6 and 1.2 per cent of the sample, respectively.
The symptoms predominantly prevailing in the sample were chronic abdominal pain (55 per cent) and changes in bowel habits (45 per cent), the study said.
Other symptoms exhibited by the patients were rectal bleeding (16 per cent), chronic diarrhoea (13 per cent), un-intended weight loss (9 per cent) and anaemia (3 per cent), the study reported.
The research evaluated all the patients using basic laboratory parameters, abdominal ultrasound and colonoscopy. For analysis, patients’ data included demographics, symptom profile, rural/urban residence and final diagnosis.
The researchers said that nearly 90 per cent of Crohn’s disease and almost all with ulcerative colitis can be diagnosed by colonoscopy and histopathology and thus, access to colonoscopy was key for early diagnosis of IBD and all colonic diseases, which is still lacking in rural areas.
The model of a low-cost mobile gastroenterology van enabled earlier diagnosis of IBD and was transferrable to other low resource countries, they said.
Further, they found the ratio of gastroenterologists to the population in India to be very low, with just one for every 5 million people.