45 Use of alternative and complementary medicines may result in delayed presentation to traditional medical specialists. There may also be a lack of awareness of possible interactions between alternative and IBD medications. Medical therapy in Asian immigrants selleckchem to the West. There are few data on the medical and surgical treatment of Asian patients with IBD in the West. Early data from the UK reported that the duration of disease until colectomy was significantly
longer in South Asians than Europeans.202 It has also been reported that colectomy of South Asians with UC in Leicestershire UK was lower than their European counterparts,5,202 but surgical rates for migrants with CD were comparable to Europeans.7 Ethnic data from the United States mainly relates to Hispanics and African Americans, reporting that
minority patients with IBD received different medical and surgical therapy than whites.62,63,203 A recent study found racial differences in patient utilization of IBD-related specialist services, emergency department visits, and use of anti-TNF therapy, independent of income and education.65 In a study derived from MK-8669 the Nationwide Inpatient Sample database between 1998 and 2003, which included 1000 hospitals in 37 states, the ratio of bowel resection for Asians compared to Caucasians was 0.31.66 Epidemiological studies of IBD in Asia have been limited by (i) a lack of patient and physician awareness of these diseases; (ii) limited access to medical facilities; (iii) difficulty in making a firm diagnosis where other diseases that mimic IBD predominate such as tuberculosis and infectious diarrhea; and
(iv) difficulty collecting population-based data. Data from referral centre cohorts are subject to bias in terms of disease onset and severity. Nonetheless, several studies have provided us with a reasonable assessment of the epidemiology in this part of the world. In the West, the incidence of CD selleck kinase inhibitor and UC remain high at 14.6 to 17.4 and 7.6 to 14.3, respectively,9–12 whereas in Asia, recent data showed a much lower incidence for CD and UC at 0.09 to 5.1 and 0.4 to 6.0, respectively. Compared with the West, which has a prevalence rate of 155.2 to 279.2 for CD and 145 to 238 for UC,10–12 studies in Asia have shown lower prevalence rates at 1.2 to 21.2 for CD and 5.3 to 63.6 for UC. Incidence and prevalence of IBD in Asia is lower than in the West; however, over the last four decades there has been a clear pattern of increase in the incidence and prevalence of CD and UC in Asia, demonstrated not only by comparing individual studies, but also by several studies reporting data over more than one time period (Table 1).
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