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Background and aimInflammatory bowel disease (IBD) is emerging in the newly industrialized countries of South Asia, South-East Asia, and the Middle East, yet epidemiological data are scarce.MethodsWe performed a cross-sectional study of IBD demographics, disease phenotype, and treatment across 38 centers in 15 countries of South Asia, South-East Asia, and Middle East. Intergroup comparisons included gross national income (GNI) per capita.ResultsAmong 10 400 patients, ulcerative colitis (UC) was twice as common as Crohn's disease (CD), with a male predominance (UC 6678, CD 3495, IBD unclassified 227, and 58% male). Peak age of onset was in the third decade, with a low proportion of elderly-onset IBD (5% age > 60). Familial IBD was rare (5%). The extent of UC was predominantly distal (proctitis/left sided 67%), with most being treated with mesalamine (94%), steroids (54%), or immunomodulators (31%). Ileocolic CD (43%) was the commonest, with low rates of perianal disease (8%) and only 6% smokers. Diagnostic delay for CD was common (median 12 months; interquartile range 5-30). Treatment of CD included mesalamine, steroids, and immunomodulators (61%, 51%, and 56%, respectively), but a fifth received empirical antitubercular therapy. Treatment with biologics was uncommon (4% UC and 13% CD), which increased in countries with higher GNI per capita. Surgery rates were 0.1 (UC) and 2 (CD) per 100 patients per year.ConclusionsThe IBD-ENC cohort provides insight into IBD in South-East Asia and the Middle East, but is not yet population based. UC is twice as common as CD, familial disease is uncommon, and rates of surgery are low. Biologic use correlates with per capita GNI.

Original publication

DOI

10.1111/jgh.15801

Type

Journal article

Journal

Journal of gastroenterology and hepatology

Publication Date

06/2022

Volume

37

Pages

1004 - 1015

Addresses

Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.

Keywords

Inflammatory Bowel Disease-Emerging Nations' Consortium (IBD-ENC) study group, Humans, Colitis, Ulcerative, Inflammatory Bowel Diseases, Crohn Disease, Mesalamine, Immunologic Factors, Incidence, Cross-Sectional Studies, Phenotype, Aged, Asia, Southeastern, Far East, Female, Male, Delayed Diagnosis