Inflammatory bowel disease in Nigerians: still a rare diagnosis?

Inflammatory bowel disease (IBD) has been thought to have a low incidence among subSaharan Africans mainly because of the sporadic cases reported from the continent in comparison with the larger numbers reported from North America and Western European countries. Is this difference based on real demographic susceptibilities or a reflection of lower level of healthcare delivery? Three cases of ulcerative colitis and one case of Crohn's disease diagnosed in a tertiary institution in northern Nigeria in the span of three years are reported. Their presentation coincided with the creation of the Gastrointestinal Surgery Unit of our hospital and with it the availability of endoscopic diagnostic procedures. All four patients were indigenous Nigerians. Our findings suggest that IBD may be more common in this part of the world than previously thought. With an increased awareness of the disease in our population, a greater utilization of modern medicine as against alternative medicine and with wider availability of diagnostic tools in our hospitals, it is our guess that more cases may be found in the future to dispel the belief that Africans are somewhat immune to this affliction.