The incidence of inflammatory bowel disease (IBD) in India has nearly doubled from 1990 to 2019, thus raising concern for doctors.

About Inflammatory Bowel Disease (IBD):

IBD is a chronic autoimmune condition where the immune system (white blood cells or the body’s soldiers) mistakenly attacks the cells in the human gut, causing ulcers in the mucosa. Paediatric Inflammatory Bowel Disease (PIBD) is a subset of IBD that occurs in individuals diagnosed before adulthood, typically before 18 years old or children and adolescents.

IBD Types:

  • Crohn’s Disease (CD): This disease can involve any part of the digestive tract, from the mouth to the anus. It causes inflammation of the entire thickness of the intestinal wall.
  • Ulcerative Colitis (UC): This disease primarily affects the inner lining (mucosa) of the large intestine (colon) and rectum.
  • Indeterminate Colitis: When the person has features of IBD but it is difficult to distinguish between UC and CD, it is termed as Indeterminate Colitis for the time being until it evolves into CD or UC.

Symptoms of IBD:

  • Abdominal pain and cramping
  • Diarrhea, often bloody
  • Urgent need to have a bowel movement (tenesmus)
  • Rectal bleeding
  • Weight loss
  • Fatigue
  • Loss of appetite

Causes of IBD:

  • Genetics: Having a close relative with IBD increases your risk.
  • Immune System Dysfunction: A malfunctioning immune system may attack the healthy tissues in your digestive tract.
  • Environmental Triggers: Certain bacteria or viruses might trigger IBD in people who are genetically susceptible.
  • Diet and Smoking: While not direct causes, diet and smoking may influence the course of IBD.


  • Medications: Anti-inflammatory drugs, immune system suppressors, and biologics are commonly used. Another group of drugs called ‘aminosalicylates’ are also used to treat milder forms of UC. 
  • Dietary changes: Certain dietary modifications may help manage symptoms.
  • Surgery: In severe cases, surgery may be necessary to remove a diseased portion of the intestine.

Increasing Incidence and Concerns:

  • Global Trend: Significant increases in North America and Western Europe. Expected to rise from 0.5% to 0.6% in the U.S.
  • India’s Situation: IBD was uncommon in India three decades ago but has become much more prevalent as the incidence of IBD in India has almost doubled from 1990 to 2019. The increase in the incidence has led to a rise in the death rate as well. 

Reasons for Rising PIBD Cases in India:

  • Westernization of Diet: Increased consumption of processed foods, refined sugars, and decreased intake of fiber, particularly in urban areas.
  • Urbanization: Environmental factors associated with urban living, such as pollution or changes in gut microbiome, might contribute.
  • Improved Diagnostics: Increased awareness of IBD among healthcare professionals and better diagnostic tools could lead to more cases being identified.
  • Genetic Predisposition: Further research is needed to explore the role of genetics in the Indian population.

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