7 WORLD GASTROENTEROLOGY NEWS APRIL 2015 Editorial | Expert Point of View | Gastro 2015: AGW/WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events States and Canada 7 except that African Americans had more than a four-fold greater prevalence of uveitis. Unlike the prior study, African Americans were less likely to have Crohn’srelated surgeries. African Americans were less likely to have penetrating CD. There were no significant differences reported in patients with UC. IBD phenotypic characteristics between Hispanics and non-Hispanic Whites in the United States was also described in a large cohort study of 325 patients (64% Hispanics), and also compared between US-born and foreign-born Hispanics 8. Hispanics were diagnosed with IBD at an older age, were less likely to have a family history, and were more likely to have UC than CD, although UC was more common in foreign-born Hispanics compared to US-born Hispanics and Whites. CD extent was similar among races, with most patients developing ileocolonic CD. There were no differences in EIM incidence among the groups in this study. Lastly, non-Hispanic Whites had a higher incidence rate of IBD-related surgical events compared to Hispanics (p<0.01). Older studies report that perianal disease has a higher prevalence among Hispanics compared to Whites and a higher prevalence of surgery for chronic UC and a much higher rate of colectomy 7. More recently, Nguyen et al. described the burden of IBD among different races utilizing the Nationwide Inpatient Sample to ascertain rates of IBD-related hospitalizations and underlying cause of death to assess IBD-related mortality. An estimated 1,810,773 adults in the United States were affected by IBD, a prevalence of 908/100,000. IBD was more common in non-Hispanic Whites compared to non-Hispanic Blacks and Hispanics. The incidence of IBD was also similarly higher in non-Hispanic Whites compared to non-Hispanic Blacks and Hispanics. There was a disproportionate higher ratio of hospitalizations, surgery, and IBD-related mortality among non- Hispanic Blacks compared with the other racial groups. In conclusion, there are racial differences in IBD phenotype in the adult population in the United States. These differences have implications in the diagnosis, management, and treatment of disease as well as complications of disease. Increased awareness and improved characterization of disease phenotypes among different ethnicities will facilitate timely diagnosis of disease, including understanding of which races may be at an increased risk for perianal disease, upper gastrointestinal involvement, and EIMs. Further research efforts and observational studies are needed to help us better understand disease patterns in these understudied populations in the United States. References 1. Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology. 2004; 126: 1504-17. 2. Hanauer SB, Feagan BG, Lichtenstein GR, et al. ACCENT I Study Group. Maintenance infliximab for Crohn’s disease: the ACCENT I randomized trial. Lancet. 2002; 359: 1541-9. 3. Vind I, Riis I, Jess T, et al. DCCD Study Group. Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003-2005: a population-based study from the Danish Crohn Colitis database. Am J Gastroenterol. 2006; 101: 1274-82. 4. Hou JK, El-Serag H, Thirumurthi S. Distribution and Manifestations of Inflammatory Bowel Disease in Asians, Hispanics and African Americans: A systematic review. Am J Gastroenterol. 2009; 104:2100-2109. 5. Wang YR, Loftus Jr. EV, Cangemi JR, Picoo MF. Racial/Ethnic and Regional Differences in the Prevalence of Inflammatory Bowel Disease in the United States. Digestion. 2013; 88: 20-25. 6. Sofia MA, Rubin DT, Hou N, Pekow J. Clinical Presentation and Disease Course of Inflammatory Bowel Disease Differs by Race in a Large Tertiary Care Hospital. Dig Dis Sci. 2014; 59:2228-2235. 7. Nguyen GC, Torres EA, Regueiro M, et al. Inflammatory Bowel Disease Characteristics Among African Americans, Hispanics, and Non-Hispanic Whites: Characterization of a Large North American Cohort. Am J Gastroenterol. 2006; 101:1012-1023. 8. Damas OM, Jahann DA, Reznik R, et al. Phenotypic Manifestations of Inflammatory Bowel Disease Differ between Hispanics and Non-Hispanic Whites: Results of a large cohort study. Am J Gastroenterol. 2013; 108: 231-239. 9. Nguyen GC, Chong CA, and Chong RY. National estimates of the burden of inflammatory bowel disease among racial and ethnic groups in the United States. Journal of Crohn’s and Colitis. 2014; 8: 288-295.
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