Is inflammatory bowel disease an unrecognized health problem in minority groups? Harvard Health Blog


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As many people know, inflammatory bowel disease (IBD) is a complex condition that affects the intestine, which is the part of the digestive system that helps digest food and get rid of water, salt and waste.

But you might not know this: In recent years in the United States, IBD is diagnosed more often among blacks, Hispanics / Hispanics, East and Southeast Asian people, or other minority groups than it has been in decades. Past.

Is this a real rise in cases? Is inflammatory bowel disease not recognized in minorities? While we don’t have all the answers yet, exploring the health inequalities in IBD and explaining its symptoms may encourage more people to get the health care they need.

What is inflammatory bowel disease?

IBD is a chronic inflammatory condition of the intestine that may develop steadily, or flare up frequently (relapse) and subside (subside).

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

  • Ulcerative colitis affects the rectum and colon alone.
  • Crohn’s disease can affect any part of the intestinal tract from the mouth to the anus, and it can lead to complications such as abscesses, strictures, and fistulas.
  • Either condition often involves organs outside the digestive system, such as the joints, skin, and eyes.

What do we know about inflammatory bowel disease among minority groups?

Traditionally, inflammatory bowel disease is believed to be a disease that most commonly affects white people. Per 100,000 individuals, IBD occurs in about 10 Hispanic / Latino individuals, 25 black individuals, and 70 non-Hispanic white individuals, according to Estimates published in 2014. However, we have recently observed an increase in IBD among other racial and ethnic groups in the United States and around the world.

Is inflammatory bowel disease not recognized in minority groups?

Some experts believe that IBD may be under-recognized or under-appreciated in minorities, which could delay the diagnosis. Late diagnosis may mean longer periods of untreated inflammation, which also increases the risk of complications, such as:

  • Stenosis (areas where the intestine narrows due to scarring)
  • Fistulas (a passage between adjacent organs or tissues that is not normally found)
  • Abscesses (an infection that may lead to a fistula if untreated)
  • Surgery
  • Bowel cancer.

One study looked at people receiving and having health care Two of the symptoms suggestive of inflammatory bowel diseaseIron deficiency anemia (low red blood count) and diarrhea. The researchers found that certain groups were less likely to receive appropriate work to find out why they had these special symptoms. Those who were black or openly insured were less likely to receive appropriate employment, compared to those who were particularly white or insured. These results also support the hypothesis that IBD may not be recognized in minorities.

What do we currently know about the health differences in IBD?

Avoidable differences – called Health disparities In health and wellness, people with inflammatory bowel disease notice. These disparities may be the result of a combination of factors affecting specific groups, including inequalities in social determinants of health, unconscious biases of medical providers, barriers to care, and differences in the complex genetic and environmental drivers of IBD that were not As well. Thoughtful enough.

Black patients with inflammatory bowel disease had higher rates of Use the emergency department – On one a studyHospitalization rates are higher, possibly because they are less likely to receive regular care from a gastroenterologist. Moreover, while the hospitalization rate in white patients with IBD was decreased, it was unchanged for black patients.

Additional research shows that black patients with Crohn’s disease are less likely to be cured, more likely to undergo surgery, and more likely to have complications after surgery. Socioeconomic status is also important: low income is associated with an increased risk of infection Severe illness, hospitalization associated with IBD, stay in the intensive care unit, and death. Another study indicates that Approximately 14% of Americans with IBD are food insecure. Moreover, it links food insecurity with the inability to take prescribed medications due to cost and difficulty paying medical bills.

What symptoms might be signs of inflammatory bowel disease?

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

  • Blood in the stool, urgency, and frequent bowel movements may be signs of ulcerative colitis.
  • Abdominal pain, nausea, vomiting, blood in the stool, and diarrhea may 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 provider. After the medical history and examination, the next steps may be additional evaluation with colonoscopy to examine the intestine, and / or upper endoscopy to look at the upper part of the digestive tract. Imaging studies may also be necessary. This evaluation will help your healthcare provider diagnose IBD or any other health problem that causes similar symptoms.

Getting an effective treatment makes a difference

Fortunately, ulcerative colitis and Crohn’s disease are treatable. Our goal in IBD treatment is stable remission to stop or relieve symptoms and ensure a high quality of life. A person with IBD can achieve this with good care. Treatment may include oral or injection medications, Dietary changesOr surgery, or a combination of these. It is important to find the right treatment and monitoring plan for each person early in the course of their illness.

I assure IBD patients that we will work together to find the best and safest treatment options for them. Inflammatory bowel disease care requires a group approach, which may include a primary care physician, gastroenterologist, pharmacist, surgeon, dietitian and other health care providers. If you have IBD, you are the central member and leader of the team; As presenters we are just coaches. It’s important to feel heard, understood, and empowered as you navigate life with IBD.

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