BACKGROUND: Inflammatory bowel disease (IBD) is comprised of Crohn's disease (CD) and ulcerative colitis (UC). There are conflicting reports on whether African Americans have a more severe disease course, presentation, and more frequent extraintestinal manifestations (EIM). We examined the precise nature of this relationship by conducting a systematic review. METHODS: Using predefined inclusion criteria we searched multiple healthcare databases and Grey literature. Eight reports met the inclusion criteria. Using the parameters as defined in the Montreal classification and the presence or absence of EIM, we compared IBD in African Americans and Caucasians. RESULTS: Over 2000 IBD cases were pooled from 8 reports with African Americans comprising 17%. African Americans and Caucasians had similar distribution of types of IBD, with CD being more common than UC in both groups (CD 76% versus 68% and UC 24% versus 32%, respectively). With respect to CD, both groups presented with nonstricturing and nonpenetrating disease behavior (55% versus 41%) more frequently and had similar rates of ileocolonic disease location (42% versus 38%), and presence of perianal disease (26% versus 29%). In UC patients, proctitis was the most frequent initial presentation in both races. Joint complications were the most frequent EIM in both African Americans (52%) and Caucasians (60%). CONCLUSIONS: This study dispels the commonly held views that African Americans with IBD generally have more colonic disease, more severe disease behavior, and more perianal disease than Caucasians. African Americans also have similar variety and frequency of EIMs as compared to Caucasians.
BACKGROUND:Inflammatory bowel disease (IBD) is comprised of Crohn's disease (CD) and ulcerative colitis (UC). There are conflicting reports on whether African Americans have a more severe disease course, presentation, and more frequent extraintestinal manifestations (EIM). We examined the precise nature of this relationship by conducting a systematic review. METHODS: Using predefined inclusion criteria we searched multiple healthcare databases and Grey literature. Eight reports met the inclusion criteria. Using the parameters as defined in the Montreal classification and the presence or absence of EIM, we compared IBD in African Americans and Caucasians. RESULTS: Over 2000 IBD cases were pooled from 8 reports with African Americans comprising 17%. African Americans and Caucasians had similar distribution of types of IBD, with CD being more common than UC in both groups (CD 76% versus 68% and UC 24% versus 32%, respectively). With respect to CD, both groups presented with nonstricturing and nonpenetrating disease behavior (55% versus 41%) more frequently and had similar rates of ileocolonic disease location (42% versus 38%), and presence of perianal disease (26% versus 29%). In UC patients, proctitis was the most frequent initial presentation in both races. Joint complications were the most frequent EIM in both African Americans (52%) and Caucasians (60%). CONCLUSIONS: This study dispels the commonly held views that African Americans with IBD generally have more colonic disease, more severe disease behavior, and more perianal disease than Caucasians. African Americans also have similar variety and frequency of EIMs as compared to Caucasians.
Authors: Dan Li; Bernadette Collins; Fernando S Velayos; Liyan Liu; James D Lewis; James E Allison; Nicole T Flowers; Susan Hutfless; Oren Abramson; Lisa J Herrinton Journal: Dig Dis Sci Date: 2013-10-31 Impact factor: 3.199
Authors: Samuel R Montgomery; Paris D Butler; Chris J Wirtalla; Karole T Collier; Rebecca L Hoffman; Cary B Aarons; Scott M Damrauer; Rachel R Kelz Journal: Am J Surg Date: 2018-05-12 Impact factor: 2.565
Authors: Leyla J Ghazi; Alison D Lydecker; Seema A Patil; Ankur Rustgi; Raymond K Cross; Mark H Flasar Journal: Dig Dis Sci Date: 2014-04-10 Impact factor: 3.199
Authors: Madeline Bertha; Arthi Vasantharoopan; Archana Kumar; Beau B Bruce; Jarod Prince; Tatyana Hofmekler; David Okou; Pankaj Chopra; Gabriel Wang; Cary Sauer; Carol J Landers; Sunny Z Hussain; Raymond K Cross; Robert N Baldassano; Michael D Kappelman; Jeffrey Katz; Jonathan S Alexander; Barbara S Kirschner; Dedrick E Moulton; Bankole O Osuntokun; Ashish Patel; Shehzad Saeed; Jan-Michael A Klapproth; Tanvi A Dhere; Marla C Dubinsky; Dermot McGovern; Subra Kugathasan Journal: Inflamm Bowel Dis Date: 2017-12-19 Impact factor: 5.325