A Review on Prevalence of Inflammatory Bowel Disease in India

  • N R Abhirami Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631
  • V V Laksmi Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631
  • A M Deepitha Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631


Inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn’s disease (CD) was believed to be a Western disease, but are now increasingly being reported from India and other Asian countries where IBD was almost unheard of 30 years ago. Now India is projected to have one of the highest IBD burden across the world. There is rising incidence and prevalence of IBD in India topping the Southeast Asian countries. The clinical presentation of IBD in India is similar to other South East Asian countries. IBD is considered as a result of the complex interaction between the environment, diet, certain medications, genetic variables and a severe autoimmune response against normal bacteria in the gut. However exact cause is still unknown. Also there exists a gender distribution in IBD. In India IBD is more prevalent in males compared to females. This review summarizes the prevalence of IBD in India and some possible risk factors contributing to it.

Keywords: Inflammatory bowel disease, prevalence, India

Keywords: Inflammatory bowel disease, prevalence, India


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Author Biographies

N R Abhirami, Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631

Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631

V V Laksmi, Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631

Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631

A M Deepitha, Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631

Department of Pharmaceutics, Elims College of Pharmacy, Thrissur, Kerala-680631


1. BJ Bernstein C, Eliakim A, Fedail S, Fried M, Gearry R, Goh K, et al. World Gastroenterology Organisation Global Guidelines Inflammatory Bowel Disease: Update August 2015. J Clin Gastroenterol 2016; 50:803‐18. https://doi.org/10.1097/MCG.0000000000000660
2. Moura AF, Goulart FM. Inflammatory Bowel Diseases: The crosslink between risk factors and antioxidant therapy.ln: Gracia-Sancho J, Salvadó J, editors. Gastrointestinal tissue: oxidative stress and dietary antioxidants, 1st edn. United States: Acadenic press; 2017. p. 99-112. https://doi.org/10.1016/B978-0-12-805377-5.00007-2
3. Waugh N, Cummins E, Royle P, Kandala N-B, Shyangdan D, Arasaradnam R, et al. Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2013. Available from: https://www.ncbi.nlm.nih.gov/books/NBK261309/ https://doi.org/10.3310/hta17550
4. Kedia S, Ahuja V. Epidemiology of Inflammatory Bowel Disease in India: The Great Shift East. Inflamm Intest Dis 2017; 2:102-115. https://doi.org/10.1159/000465522
5. Ray G. Inflammatory bowel disease in India - Past, present and future. World J Gastroenterol. 2016; 22:8123-36 https://doi.org/10.3748/wjg.v22.i36.8123
6. Kondamudi PK, Malyandi R, Eaga C, Aggarwal D. Drugs as causative agents and therapeutic agents in inflammatory bowel disease. Acta Pharmaceutica Sinica B 2013; 3:289-296, https://doi.org/10.1016/j.apsb.2013.06.004
7. Alatab, Sepanlou S, Ikuta SG, Vahedi K, Bisignano H, Safiri C et al. The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2017; 5:17-30 https://doi.org/10.1016/S2468-1253(19)30333-4
8. Khosla SN, Girdhar NK, Lal S, Mishra DS. Epidemiology of ulcerative colitisin hospital and select general population of northern India. J Assoc Physicians India 1986; 34:405-7.
9. Sood A, Midha V, Sood N, Bhatia AS, Avasthi G. Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut 2003; 52:1587-1590. https://doi.org/10.1136/gut.52.11.1587
10. Yang SK, Loftus EV Jr, Sandborn WJ: Epidemiology of inflammatory bowel disease in Asia. Inflamm Bowel Dis 2001; 7:260-270. https://doi.org/10.1097/00054725-200108000-00013
11. Sharma JB, Sharma B, Sharma R, Mahajan SK, Raina R, Sharma P. The profile of inflammatory bowel disease in natives of Western Himalayas. Tropical Gastroenterology 2017; 38:115-121 https://doi.org/10.7869/tg.408
12. Philip M, Augustine P, Thomas V, Ramesh GN, Vinayakumar KR, Ramachandran TM, et al. Multi-center prospective survey of inflammatory bowel diseases in Kerala: More than 2000 cases. Indian J Gastroenterol 2017; 36:459-467. https://doi.org/10.1007/s12664-017-0809-6
13. Sathiyasekaran M, Bavanandam S, Sankaranarayanan S, Mohan N, Geetha M, Wadhwa N, et al. A questionnaire survey of pediatric inflammatory bowel disease in India. Indian J Gastroenterol 2014; 33:543-9. https://doi.org/10.1007/s12664-014-0507-6
14. Shivananda S, Lennard-Jones J, Logan R, Fear N, Price A, Carpenter L, van Blankenstein M: Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European collaborative study on inflammatory Bowel disease (EC-IBD). Gut 1996; 39:690-7. https://doi.org/10.1136/gut.39.5.690
15. Makharia GK, Ramakrishna BS, Abraham P, Choudhuri G, Misra P, Ahuja V, et al. Indian Society of Gastroenterology Task Force on Inflammatory Bowel Disease: Survey of inflammatory bowel diseases in India. Indian J Gastroenterol 2012; 31:299-306 https://doi.org/10.1007/s12664-012-0258-1
16. Gunisetty S, Tiwari S, Bardia A, Phanibhushan M, Satti V, Habeeb M, et al. The epidemiology and prevalence of ulcerative colitis in the South of India. Open Journal of Immunology 2012; 2:144-8. https://doi.org/10.4236/oji.2012.24018
17. Probert CS, Jayanthi V, Pinder D, Wicks AC, Mayberry JF. Epidemiological study of ulcerative proctocolitis in Indian migrants and the indigenous population of Leicestershire. Gut. 1992; 33(5):687‐693. https://doi.org/10.1136/gut.33.5.687
18. Acharyya BC, Acharyya S, Chakrabarty H. Incidence of Inflammatory bowel disease in a tertiary centre of Eastern India. Adv Res Gastroentero Hepatol 2018; 9:e555774. https://doi.org/10.19080/ARGH.2018.09.555774
19. Park SC, Jeen YT. Genetic Studies of Inflammatory Bowel Disease-Focusing on Asian Patients. Cells 2019; 5:404. https://doi.org/10.3390/cells8050404
20. Juyal G, Negi S, Sood A, Gupta A, Prasad P, Senapati S, et al. Genome wide association scan in northindians reveals three novel hla-independent risk loci for ulcerative colitis. Gut 2015; 64:571-79. https://doi.org/10.1136/gutjnl-2013-306625
21. Pugazhendhi S, Santhanam S, Venkataraman J, Creveaux I, Ramakrishna BS. NOD2 gene mutations associate weakly with ulcerative colitis but not with Crohn's disease in Indian patients with inflammatory bowel disease. Gene 2013; 512:309‐13 https://doi.org/10.1016/j.gene.2012.10.015
22. Baskaran K, Pugazhendhi S, Ramakrishna BS: Protective association of tumor necrosis factor superfamily 15 (TNFSF15) polymorphic haplotype with Ulcerative Colitis and Crohn's disease in an Indian population. PLoS One 2014; 9:e114665 https://doi.org/10.1371/journal.pone.0114665
23. Meena NK, Verma R, Verma N, Ahuja V, Paul J: TLR4 D299G polymorphism modulates cytokine expression in ulcerative colitis. J Clin Gastroenterol 2013; 47:773-80 https://doi.org/10.1097/MCG.0b013e31828a6e93
24. Kaoutari AE, Armougom F, Gordon JI, Raoult D, Henrissat B.The abundance and variety of carbohydrate‐active enzymes in the human gut microbiota. Nat Rev Microbiol 2013; 11:497-504 https://doi.org/10.1038/nrmicro3050
25. Jandhyala SM, Talukdar R, Subramanyam C, Vuyyuru H, Sasikala M, Nageshwar Reddy D. Role of the normal gut microbiota. World J. Gastroenterol 2015; 21:8787-803. https://doi.org/10.3748/wjg.v21.i29.8787
26. Darfeuille-Michaud A, Boudeau J, Bulois P, Neut, C, Glasser AL, Barnich N, et al. High prevalence of adherent-invasive Escherichia coli associated with ileal mucosa in Crohn's disease. Gastroenterology 2004; 127:412-21 https://doi.org/10.1053/j.gastro.2004.04.061
27. Ohkusa T, Okayasu I, Ogihara T, Morita K, Ogawa M, Sato N. Induction of experimental ulcerative colitis by Fusobacterium varium isolated from colonic mucosa of patients with ulcerative colitis. Gut 2003; 52:79-83. https://doi.org/10.1136/gut.52.1.79
28. Kumari R, Ahuja V, Paul J. Fluctuations in butyrate-producing bacteria in ulcerative colitis patients of North India. World J Gastroenterol 2013; 19:3404-14. https://doi.org/10.3748/wjg.v19.i22.3404
29. Bernstein CN, Burchill C, Targownik LE, Singh H, Roos LL. Events within the first year of life, but not the neonatal period, affect risk for later development of inflammatory bowel diseases. Gastroenterology. 2019; 156:2190-7. https://doi.org/10.1053/j.gastro.2019.02.004
30. Dubeau MF, Iacucci M, Beck PL, Moran GW, Kaplan GG, Ghosh S, et al. Drug-induced inflammatory bowel disease and IBD-like conditions. Inflamm Bowel Dis 2013; 19:445-56. https://doi.org/10.1002/ibd.22990
31. Long MD, Kappelman MD, Martin CF, Chen W, Anton K, Sandler RS. Role of nonsteroidal anti-inflammatory drugs in exacerbations of inflammatory bowel disease. J Clin Gastroenterol 2016; 50:152-6. https://doi.org/10.1097/MCG.0000000000000421
32. Wang X, Fan X, Deng H, Zhang X, Zhang K, Xu J, et al. Use of oral contraceptives and risk of ulcerative colitis - a systematic review and meta-analysis. Pharmacol Res 2018; 139:367-74 https://doi.org/10.1016/j.phrs.2018.11.036
33. Thomas G, Rhodes J, Greeen J, Richardson Cl. Role of smoking in inflammatory bowel disease: implications for therapy. Postgraduate Medical Journal 2000; 76:273-79. https://doi.org/10.1136/pmj.76.895.273
34. Nos P, Domènech E. Management of Crohn's disease in smokers: Is an alternative approach necessary? World J Gastroenterol 2011; 17:3567-74. https://doi.org/10.3748/wjg.v17.i31.3567
35. Cosnes J, Beaugerie L, Carbonnel F, Gendre JP. Smoking cessation and the course of Crohn's disease: an intervention study. Gastroenterology 2001; 120:1093-9. https://doi.org/10.1053/gast.2001.23231
36. Cosnes J, Carbonnel F, Carrat F, Beaugerie L, Cattan S, Gendre J. Effects of current and former cigarette smoking on the clinical course of Crohn's disease. Aliment Pharmacol Ther. 1999; 13:1403-11. https://doi.org/10.1046/j.1365-2036.1999.00630.x
37. Ekbom A. Epidemiology of inflammatory bowel disease. In: Bistrian BR, Walker-Smith JA, editors. Inflammatory bowel disease. Nestle nutrition workshop series- clinical & performance programme. Nestle Ltd: Karger, Basel; 1999. pp. 7-21. https://doi.org/10.1159/000061792
38. Arora U, Ananthakrishnan AN, Kedia S, Bopana S, Mouli PV, Yadav PD. Effect of oral tobacco use and smoking on outcomes of Crohn's disease in India. J Gastroenterol Hepatol 2018; 33:134-40. https://doi.org/10.1111/jgh.13815
39. Wang P, Hu J, Ghadermarzi S, Raza A, O'Connell D, Xiao A, et al. Smoking and Inflammatory Bowel Disease: A Comparison of China, India, and the USA. Dig Dis Sci. 2018; 63:2703-13. https://doi.org/10.1007/s10620-018-5142-0
40. Bonaz BL, Bernstein CN. Brain-gut interactions in inflammatory bowel disease. Gastroenterology. 2013; 144(1):36-49. https://doi.org/10.1053/j.gastro.2012.10.003
41. Ananthakrishnan AN, Long MD, Martin CF, Sandler RS, Kappelman MD. Sleep disturbance and risk of active disease in patients with Crohn's disease and ulcerative colitis. Clin Gastroenterol Hepatol 2013; 11:965-71. https://doi.org/10.1016/j.cgh.2013.01.021
42. Ananthakrishnan AN, Khalili H, Konijeti GG, Higuchi LM, de Silva P, Fuchs CS, et al. Sleep duration affects risk for ulcerative colitis: a prospective cohort study. Clin Gastroenterol Hepatol. 2014; 12:1879-86. https://doi.org/10.1016/j.cgh.2014.04.021
43. Sood A, Ahuja V, Kedia S, Midha V, Mahajan R, Mehta V, et al. Diet and inflammatory bowel disease: The Asian Working Group guidelines. Indian J Gastroenterol 2019; 38:220-46. https://doi.org/10.1007/s12664-019-00976-1
44. Vidal-Lletjós S, Beaumont M, Tomé D, Benamouzig R, Blachier F, Lan A. Dietary Protein and Amino Acid Supplementation in Inflammatory Bowel Disease Course: What Impact on the Colonic Mucosa? Nutrients 2017; 9:310. https://doi.org/10.3390/nu9030310
45. Froicu M, Zhu Y, Cantorna MT. Vitamin D receptor isrequired to control gastrointestinal immunity in IL-10 knockout mice. Immunology 2006; 117:310-8. https://doi.org/10.1111/j.1365-2567.2005.02290.x
46. Kaplan GG, Hubbard J, Korzenik J, Sands B, Panaccione R, Ghosh S, et al. The inflammatory bowel diseases and ambient air pollution: a novel association. Am J Gastroenterol 2010; 105:2412-2419. https://doi.org/10.1038/ajg.2010.252
47. Kish L, Hotte N, Kaplan GG, Vincent R, Tso R, Ganzle M, et al. Environmental particulate matter induces murine intestinal inflammatory responses and alters the gut microbiome. PLoS ONE 2018; 8: e62220. https://doi.org/10.1371/journal.pone.0062220
48. Ananthakrishnan AN, McGinley EL, Binion DG, Saeian K. Ambient air pollution correlates with hospitalizations for inflammatory bowel disease: an ecologic analysis. Inflamm Bowel Dis 2011; 17:1138-45. https://doi.org/10.1002/ibd.21455
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Abhirami NR, Laksmi VV, Deepitha AM. A Review on Prevalence of Inflammatory Bowel Disease in India. JDDT [Internet]. 15Nov.2022 [cited 9Dec.2022];12(6):219-23. Available from: https://jddtonline.info/index.php/jddt/article/view/5403