Is IBD an underrecognized health problem in minority groups?

As many people know, inflammatory bowel disease (IBD) is a complex disease affecting the intestine, which is the part of the digestive tract that helps digest food and remove water, salt, and salts. waste.

But you might not know it: In recent years in the United States, IBD has been diagnosed more often in black, Hispanic / Latin people, East and Southeast Asian people, or other groups. minorities than in recent decades.

Is this a real increase in cases? Are ITNs under-recognized in minority populations? While we don’t have all the answers yet, exploring the health disparities in IBD and explaining its symptoms can encourage more people to get the health care they need.

What is the IBD?

IBD is a chronic inflammatory bowel disease that can progress steadily or flare up repeatedly (relapse) and subside (remission).

The two main types of IBD are ulcerative colitis (UC) and Crohn’s disease (CD):

  • Ulcerative colitis only affects the rectum and colon.
  • Crohn’s disease can affect any part of the intestinal tract, from the mouth to the anus, and can lead to complications such as abscesses, strictures, and fistulas.
  • Both conditions frequently involve organs outside the gastrointestinal tract, such as the joints, skin, and eyes.

What do we know about IBD among minority groups?

Traditionally, IBD has been viewed as a disease that largely affects Caucasians. Per 100,000 people, IBD occurs in about 10 Hispanic / Latinox, 25 black and 70 white non-Hispanic individuals, according to estimates released in 2014. However, more recently we have seen an increase in IBD among other racial and racial people. ethnic groups in the United States and around the world.

Is inflammatory bowel disease under-recognized in minority groups?

Some experts believe that IBD may be under-recognized or underestimated in minority populations, which could lead to delays in diagnoses. Delayed diagnosis could mean longer periods of untreated inflammation, which also increases the risk of complications, such as

  • strictures (areas where the intestine narrows due to scarring)
  • fistulas (a passage between nearby organs or tissues that are not normally there)
  • abscess (an infection that can lead to a fistula if left untreated)
  • surgery
  • bowel cancer.

One study looked at people receiving health care who had two symptoms suggestive of IBD: iron deficiency anemia (low red blood cell count) and diarrhea. Researchers found that certain groups were less likely to receive a proper checkup on why they had these particular symptoms. Those who were black or publicly insured were less likely to receive the appropriate balance sheet, compared to those who were white or privately insured. These results further support the hypothesis that IBD may be under-recognized in minority populations.

What do we currently know about health disparities in IBD?

Avoidable differences – called health disparities – in health and well-being are seen in people with inflammatory bowel disease. These disparities may be due to a range of factors affecting certain groups, including inequalities in the social determinants of health, unconscious biases of health care providers, barriers to care, and differences in complex genetic and environmental driving forces. IBD that has not been. sufficiently studied.

Black patients with IBD experience higher rates of emergency department use – and, in one study, higher hospitalization rates, possibly because they are less likely to receive regular care. a specialist in gastroenterology. Additionally, while the hospitalization rate for white IBD patients has declined, it remains unchanged for black patients.

Additional research shows that black patients with Crohn’s disease are less likely to be in remission, more likely to have surgery, and more likely to experience complications after surgery. Socio-economic status is also important: lower income is linked to a higher risk of serious illness, IBD-related hospitalizations, intensive care stays and death. Another study reports that about 14% of Americans with IBD are food insecure. Additionally, he links food insecurity with the inability to take prescribed medications due to cost and difficulty paying medical bills.

What symptoms can be signs of inflammatory bowel disease?

A variety of symptoms can be signs of inflammatory bowel disease:

  • Blood in your stool, urgency, and increased stool frequency can be signs of ulcerative colitis.
  • Abdominal pain, nausea, vomiting, blood in your stool, and diarrhea can be signs of Crohn’s disease.

If you have any of these symptoms, especially if you notice blood in your stool, talk to your healthcare professional. After a medical history and examination, the next steps may be a more in-depth evaluation with a colonoscopy to examine the intestine, and / or an upper endoscopy to examine the upper part of the digestive system. Imaging studies may also be necessary. This assessment will help your healthcare professional diagnose IBD or another condition causing similar symptoms.

Getting effective treatment makes the difference

Fortunately, ulcerative colitis and Crohn’s disease are both treatable conditions. Our goal in the treatment of IBD is stable remission to arrest or relieve symptoms and ensure a high quality of life. Anyone with IBD can achieve this with good care. Treatment may include drugs given by mouth or given as an infusion, dietary changes, surgery, or a combination of these. It is important to find the right treatment and follow-up plan for each person early in their illness.

I assure my IBD patients that we will work together to find the best and safest treatment options for them. IBD care requires a team approach, which may include a primary care physician, gastroenterologist, pharmacist, surgeon, dietitian, and other healthcare professionals. If you have IBD, you are the central member and captain of the team; as providers, we are only coaches. It is important that you feel listened to, understood and empowered in your life with IBD.

Follow me on twitter @AdjoaGIMD

The Job Are IBDs an under-recognized health problem in minority groups? first appeared on the Harvard Health Blog.

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