Article Text
Abstract
Introduction Previous studies suggest changing incidence and prevalence of Inflammatory Bowel Disease (IBD) in migrant groups, particularly South Asians. Most of these studies were retrospective and within local hospital settings. They also suggest a different phenotype: pan-colonic ulcerative colitis (UC) was commoner in migrants from India compared with Caucasians. One study in East London reported on differing phenotype of Crohn’s disease (CD) in Bangladeshis; they developed perianal complications, received anti-TNFs earlier and underwent surgery later than Caucasians. We examined the ethnic diversity of patients with IBD attending hospitals in England.
Method We identified patients from a national hospital episodes statistics (HES) database between 1997–2012. The database captures all hospital episodes between these dates. Patients were identified according to ICD-10 diagnosis code; K51 for UC and K52 for CD. Only patients with a documented ethnicity code were included.
Results Patients with an ethnicity code and a diagnosis of UC and CD are shown in Table 1. Only 35.3% of cases had an ethnicity code. The majority of patients were of White European (Caucasian) descent. In Bangladeshis, CD was commoner than UC in contrast to Indian and Pakistani ethnic groups where UC was commoner than CD.
Conclusion Bangladeshis are more likely to have CD compared with Indians and Pakistanis and require more hospital interventions for CD than UC. This may represent a more aggressive phenotype consistent with previous literature. This data is limited by the nature of the HES database: retrospective, hospital episodes and incomplete coding for ethnicity. Prospective studies are needed to validate these findings and explore underlying reasons for the difference.
Disclosure of interest None Declared.