Inflammatory bowel diseases in Tamil Nadu: A survey of demographics, clinical profile, and practices
Yewale RV, Natarajan K, Ubal Dhus J, Parameswaran SA, Ramaswamy Palaniswamy K, Babu Vinish D, Somasundaram A, Ramakrishnan A, Karmegam S, Arun RS, Manmohan US, Mahadevan B, Harri Prasad B, Chandrasekar TS, Gokul BJ, Dutta A, Joseph AJ, Venkatraman J, Ganesh P, Shanmuganathan S, Alagammai PL, Ramasubramanian R, Venkatakrishnan L, Ganesan R, Chandrasekaran Arun A, Srinivas S, Kannan M, Revathy MS, Sathiyasekaran M, Sarangapani A, Rajesh N, Arulselvan V, Aravind A, Premkumar K, Kavitha S, Varadarajulu HV, Manimaran M, Basumani P, Murali A, Ramakrishna BS. Published in Nov 2021, an Open access Journal of Gastroenterology and Hepatology.
Abstract
Background: Inflammatory bowel disease (IBD) is increasingly diagnosed in South Asia. This survey by the Tamil Nadu Chapter of the Indian Society of Gastroenterology (TNISG) documents the demography, clinical profile, and therapeutic practices related to IBD in Tamil Nadu.
Methods: TNISG members from 32 institutions completed an online cross-sectional questionnaire on IBD patients from March 2020 to January 2021.
Results: Of 1295 adult IBD patients, 654 had Crohn's disease (CD), 499 ulcerative colitis (UC), and 42 IBD-unclassified (IBD-U). CD and UC showed a unimodal age distribution. A total of 55% were graduates or postgraduates. A positive family history was noted in 30, other risk factors were uncommon. In CD, the pattern of involvement was ileocolonic (42.8%), ileal (34.7%), colonic (18.9%), and upper gastrointestinal (3.5%); while in UC, disease was characterized as extensive (44.9%), left-sided (41.7%), or proctitis (13.4%). Perineal disease, perianal fistulae, and bowel obstruction were noted in 4.3, 14.0, and 23.5%, respectively, of CD. The most widely used drugs were mesalamine, azathioprine, and corticosteroids. Surgery was undertaken in 141 patients with CD and 23 patients with UC. Of the 138 patients with pediatric IBD (≤16 years), 23 were characterized as very early onset IBD (VEO-IBD), 27 as early-onset, and 88 as adolescent IBD. VEO-IBD were more likely to have a positive family history of IBD and were more likely to have perineal disease and to have the IBD-U phenotype. Among pediatric IBD patients, corticosteroids, mesalamine, and azathioprine were the most commonly used medications, while 25 pediatric patients received biologics.
Conclusion: This study provides important information on demography, clinical profile, and treatment practices of IBD in India.
Keywords: Crohn's disease; epidemiology; pediatric inflammatory bowel disease; ulcerative colitis.