Irritable Bowel Disease is now an epidemic: Why India is seeing a surge

India Today

2 days ago

A silent yet formidable health challenge is gaining ground across India: Inflammatory Bowel Disease (IBD).Once seldom encountered in clinical practice, this chronic condition of the gastrointestinal tract, that includes ulcerative colitis and Crohn's disease, is now surfacing with greater frequency in both metropolitan and smaller urban centres.As diagnoses rise and medical practitioners face mounting complexities in treatment and detection, IBD is emerging as a public health concern demanding urgent attention.advertisement
WHAT IS IBD? Irritable Bowel Disease (IBD) is a long-term condition that causes swelling and pain in the digestive tract.There are two types of IBD: Crohn's disease (inflammation in any part of the digestive tract) and ulcerative colitis (inflammation and ulcers in the colon and rectum).People with IBD often have stomach pain, diarrhea, tiredness, and weight loss. It's different from IBS and needs medical care to manage symptoms and flare-ups.SHARP RISE IN IBD IN INDIAA global study by researchers from the University of Chicago suggested that IBD is rising not just in the Western countries, but it is now infiltrating developing countries like India, even though a large population is vegetarian.
People with IBD often have stomach pain, diarrhea, tiredness, and weight loss. It's different from IBS and needs medical care to manage symptoms and flare-ups. ()
advertisement"As a chronic inflammatory condition that is driven by immune system responses, IBD has been linked to so-called Western diets that are high in processed foods, animal products, and sugar while also low in fruits, vegetables, and whole grains. People in industrialising economies tend to adopt more elements of this diet, but that alone doesn't tell the full story. IBD is increasing in India, for example, which has a high proportion of people who are vegetarian," the researchers wrote in the peer-reviewed journal Nature.Recent epidemiological projections paint an alarming picture: by 2035, India could be home to over two million IBD patients, a fourfold increase in less than two decades.Doctors attribute this exponential rise to a confluence of environmental, dietary, and lifestyle changes, underscoring the intersection between modernity and the gut microbiome (micro-organisms in the digestive tract).A 2023 Lancet study by the IBD Centre at the Asian Institute of Gastroenterology (AIG), Hyderabad, underscores the gravity of the trend. According to the findings, the prevalence of IBD in the region surged from a modest 0.1% in 2006 to over 5% by 2022, a staggering escalation that reflects broader national patterns.
Doctors attribute this exponential rise to a confluence of environmental, dietary, and lifestyle changes, underscoring the intersection between modernity and the gut microbiome. ()
"India is witnessing a rapid increase in IBD cases due to a transition from traditional Indian diets rich in fibre and natural foods to a more Westernised intake of processed foods, saturated fats, and sugars. This dietary shift has altered gut microbiota weakening intestinal barriers and potentially triggering the inflammation," explained Dr. Sharad Malhotra, senior consultant & director of gastroenterology at Aakash Healthcare.EARLY ANTIBIOTIC USEAmong the key factors that causes the development of IBD is early antibiotic exposure. Mounting evidence suggests that disruption of the gut microbiota during critical developmental stages may have long-lasting consequences."Antibiotic exposure during early childhood can disrupt the developing gut microbiota, leading to long-term alterations in microbial composition and function. This dysbiosis has been linked to an increased risk of inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, later in life," noted Dr. Sunil Rana, associate director and head of internal medicine, Asian Hospital.advertisementMISDIAGNOSIS OF IBDThe diagnostic landscape in India presents its own unique challenges. IBD's symptomatic presentation, often including abdominal discomfort, chronic diarrhea, and unexplained weight loss, closely mimics that of other prevalent gastrointestinal conditions, particularly intestinal tuberculosis.This overlap has historically led to misdiagnoses with serious clinical implications.
Antibiotic exposure during early childhood can disrupt the developing gut microbiota. ()
"The histopathological distinction between IBD or Crohn's and intestinal tuberculosis remains a critical challenge in India. Accurate biopsy analysis is essential because misdiagnosis can lead to inappropriate therapy and serious complications. Such patients may be subjected to ineffective treatments, delaying appropriate management and increasing morbidity," says Dr. Suhas Udgirkar, consultant of gastroenterology at Jupiter Hospital.TREATMENT OF IBDClinicians are calling for a multidisciplinary approach to address these diagnostic difficulties."Many patients present with non-specific symptoms, making early detection difficult. A multidisciplinary approach is necessary, integrating clinical evaluation with detailed investigations to manage IBD effectively," added Dr. Rana.But the barriers are not merely biological or infrastructural. Accurate diagnosis often relies on a combination of physical examinations, laboratory work, and endoscopic procedures, resources frequently unavailable in rural or non-specialist settings.
Clinicians are calling for a multidisciplinary approach to address these diagnostic difficulties. ()
advertisement"The symptoms of IBD overlap with Irritable Bowel Syndrome. This does delay diagnosis. Individuals with alarming symptoms such as bleeding and severe abdominal pain need a complete evaluation. However, there is no single diagnostic test for Ulcerative Colitis or Crohn's Disease," explained Dr. Aakaar Kapoor, CEO of City XRay and Scan Clinic.Compounding the issue is the social stigma surrounding chronic illness, particularly one that affects bowel health. The result: a culture of silence that delays care and exacerbates patient outcomes.As India grapples with the mounting burden of IBD, experts agree that timely diagnosis, access to advanced diagnostics, and de-stigmatising the disease are essential to slowing its spread.Must Watch