Study shows ethnic differences in inflammatory bowel disease
South Asian patients with inflammatory bowel disease (IBD) are more likely to have a certain form of the disease and be diagnosed younger than their white counterparts, according to research published in the Journal of Crohn’s and Colitis.
The study, funded by Bowel Research UK and the National Institute of Health and Care Research (NIHR) Imperial Biomedical Research Centre (BRC), is the largest analysis to date on South Asian IBD patients based in the UK.
IBD is a group of diseases that cause inflammation in the digestive tract. Two common types are ulcerative colitis (UC) and Crohn's disease (CD). UC affects the large intestine, while CD can affect any part of the digestive tract, from the mouth to the anus. Common symptoms of IBD include diarrhoea, a sudden urge to use the bathroom, and abdominal pain. Many people with IBD require medication or surgery to help control their symptoms. Around 300,000 people suffer from IBD in the UK and most cases are diagnosed before the age of 35.
The researchers analysed data from more than 30,000 patients. They found that in South Asian IBD patients, ulcerative colitis was more common than in their white counterparts (57% vs 45% of the IBD cohorts studied). South Asian patients were also diagnosed on average two years younger. IBD was also more common in South Asian men than women, whereas in the white population the genders were more equally affected.
Dr Sharmili Balarajah, a Bowel Research UK researcher and gastroenterologist at Imperial College Healthcare NHS Trust, said: “Our current understanding of IBD is primarily derived from studies focused on white populations. Our research is groundbreaking, as it reveals distinct variations in IBD among different ethnic groups, especially South Asians. By understanding these differences, we can develop more personalised treatment approaches for IBD patients, ensuring that their specific needs are addressed.”
The researchers also found the disease behaved differently in the different ethnicities. South Asians were more likely to have the large bowel affected, and less likely to have narrowing of the bowel (stricturing) in CD. They were also more likely to have extensive large bowel inflammation in UC than in white patients.
The research also assessed whether the two ethnic groups received the same level of care and found that there was consistency in the treatment received regardless of ethnicity.
Lindsay Easton, CEO of Bowel Research UK, said: “IBD can be a debilitating disease that has a huge impact on people who are often diagnosed when they’re just in their 20s and 30s. We know very little about the causes of IBD and there’s no cure. Research like this, and other projects we’re funding, shed light on how we can tailor care for different groups and how the disease develops.”
Research at Imperial College Healthcare is supported by the NIHR Imperial BRC, a translational research partnership between Imperial College Healthcare NHS Trust and Imperial College London, which was awarded £95m in 2022 to continue developing new experimental treatments and diagnostics for patients.
