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1. Inflammatory bowel diseases in Tamil Nadu: A survey of demographics, clinical profile, and practices

Author

Rohan V Yewale, Kartik Natarajan, Jeyaraj Ubal Dhus, Sarojini Ashok Parameswaran, Kallipatti RamaswamyPalaniswamy, Doraisamy Babu Vinish, Aravindh Somasundaram, Arulraj Ramakrishnan, Sibithooran Karmegam, Ramaswamy Saraswathy Arun, Ujjani Shankaraiah Manmohan, Balakrishnan Mahadevan, Baskkaran Harri Prasad, Toguluva Seshadri Chandrasekar, Bollu Janakan Gokul, Amit Dutta, Anjilivelil Joseph Joseph, Jayanthi Venkatraman, Panchapakesan Ganesh, Subramanyam Shanmuganathan, Palaniappan L Alagammai, Ramalingam Ramasubramanian, Leelakrishnan Venkatakrishnan, Ramamoorthi Ganesan, Arunachalam ChandrasekaranArun, Sankaranarayanan Srinivas, Mariappan Kannan, M Shanmugam Revathy, Malathi Sathiyasekaran, Arulprakash Sarangapani, Natrajan Rajesh, Velusamy Arulselvan, Arumugam Aravind, Karunakaran Premkumar, Sampath Kavitha, Hema Vijayalakshmi Varadarajulu, Murugesan Manimaran, Pandurangan Basumani, Ananthavadivelu Murali, and Balakrishnan Siddartha Ramakrishna

Subjects
Crohn's disease, epidemiology, pediatric inflammatory bowel disease, ulcerative colitis, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

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.

Published
2021
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2. Inflammatory bowel diseases in Tamil Nadu: A survey of demographics, clinical profile, and practices

Author

Sampath Kavitha, Arulprakash Sarangapani, Rohan Yewale, Balakrishnan S. Ramakrishna, Doraisamy Babu Vinish, Jeyaraj Ubal Dhus, Aravindh Somasundaram, M Shanmugam Revathy, Leelakrishnan Venkatakrishnan, Ananthavadivelu Murali, Kartik Natarajan, Sibithooran Karmegam, Amit Kumar Dutta, Jayanthi Venkatraman, Balakrishnan Mahadevan, Malathi Sathiyasekaran, Arunachalam Chandrasekaran Arun, Subramanyam Shanmuganathan, Ramaswamy Saraswathy Arun, Ramalingam Ramasubramanian, Natrajan Rajesh, Baskkaran Harri Prasad, Ramamoorthi Ganesan, Sarojini Ashok Parameswaran, Arumugam Aravind, Panchapakesan Ganesh, Velusamy Arulselvan, Bollu Janakan Gokul, Hema Vijayalakshmi Varadarajulu, Sankaranarayanan Srinivas, Toguluva Seshadri Chandrasekar, Kallipatti Ramaswamy Palaniswamy, Karunakaran Premkumar, Murugesan Manimaran, Mariappan Kannan, Palaniappan L Alagammai, Arulraj Ramakrishnan, Pandurangan Basumani, A J Joseph, and Ujjani Shankaraiah Manmohan

Subjects
medicine.medical_specialty, Azathioprine, RC799-869, digestive system, Inflammatory bowel disease, Internal medicine, Epidemiology, pediatric inflammatory bowel disease, medicine, Family history, Proctitis, ulcerative colitis, Crohn's disease, Hepatology, business.industry, Gastroenterology, Original Articles, Diseases of the digestive system. Gastroenterology, medicine.disease, Ulcerative colitis, digestive system diseases, Bowel obstruction, Original Article, epidemiology, business, medicine.drug
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., Regional differences in inflammatory bowel disease (IBD) profile inform our understanding of the disease as well as prevention, and health planning. This study provides a snapshot of IBD presentation and practices in India at a time when the country is in the second of four phases of IBD transition. The apparently mild nature of IBD, the consequent widespread use of mesalamine, and the association of Crohn's disease with higher levels of education, compared to ulcerative colitis, are of notable interest.

Published
2021

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