• Posted January 5, 2024

Crohn's, Colitis Vary by Race, Gender

Crohn's disease and ulcerative colitis show different patterns of incidence by race, gender and even place of birth, a new U.S. study finds.

The two illnesses are each classified as an inflammatory bowel disorder (IBD) -- conditions that trigger a chronic inflammation of the gastrointestinal tract.

The new research, from Rutgers University and other centers, found IBDs vary widely, according to patient demographics.

“IBD has historically been a disease of Caucasian populations in Europe and North America, but now we're seeing it among all races and in people all over the globe, so it's now important to study how it manifests in different groups,” noted study senior author Lea Ann Chen. She's an assistant professor of medicine and pharmacology at Rutgers Robert Wood Johnson Medical School in New Brunswick, N.J.

Chen's team analyzed the medical records of 525 patients who underwent treatment for an IBD at New York City's Bellevue Hospital between 1997 and 2017.

Bellevue is a "safety net" hospital, where most patients are of similar income, the researchers noted. The patients were racially diverse, however: 29.8% white, 27.4% Hispanic, 21.7% Black and 13% Asian.

That diversity was mirrored in the patient profiles for both Crohn's and ulcerative colitis.

Using white patients for comparison purposes, Chen's team found that:

• Among Asian patients, men were twice as likely to have an IBD as women, regardless of whether they'd been born in the United States or abroad.

• Black patients were more than twice as likely to require a resection (surgical removal) of part of their intestine, compared to white patients.

• Crohn's diagnoses were more likely among Black patients born in the United States, whereas colitis was more likely among Black patients born abroad.

• Symptoms of ulcerative colitis and Crohn's tended to be milder if the patient had not been born in the United States, regardless of their race. These patients typically were diagnosed later in life, required fewer surgeries and medications, and had fewer complications, compared to native-born Americans.

The last finding was "particularly true among Black patients," Chen noted in a Rutgers news release. "Those who were born here were far more likely to develop Crohn's disease and its complications compared to those who were born abroad.”

In other cases, genes may have played a role.

For example, “the difference in case numbers between Asian men and women was striking, and that difference appeared both among U.S.-born and foreign-born patients,” Chen noted. “It appears that East Asian women -- because most of the Asian patients in our study population were East Asian -- may have some sort of genetic protection against IBD.”

The study was published recently in the journal Gastro Hep Advances.

More information

Find out more about inflammatory bowel disease at the Crohn's & Colitis Foundation.

SOURCE: Rutgers University, news release, Jan. 3, 2024