What is Inflammatory bowel disease? Why is it rising in India?

NEW DELHI: Inflammatory bowel disease (IBD), which arises from a combination of genetic factors, gut environment, and immune responses, is seeing a significant rise in India, said health experts on Saturday.

The IBD Day is observed every year on May 19. The theme this year is 'IBD Has No Borders'.

The condition is categorised mainly into Crohn's disease (affecting the small intestine), ulcerative colitis (affecting the large intestine), indeterminate colitis, and microscopic colitis (diagnosed via biopsy).

"Genetically predisposed individuals inherit susceptibility from their parents. The gut environment, particularly the balance of bacteria, plays a crucial role; a healthy gut typically contains 60-70 per cent good bacteria and 30-40 per cent bad bacteria," Mahesh Kumar Gupta, Senior Consultant -- Gastroenterology, Marengo Asia Hospital, Gurugram, told IANS.

"Disruption in this balance, often due to poor dietary habits, lack of sleep, or excessive consumption of junk food and preservatives, can trigger inflammation. The immune system's interaction with genetic and bacterial factors further contributes to intestinal ulcerations seen in IBD," he said.

Common symptoms of IBD include bloody diarrhoea, weight loss, fever, fatigue, abdominal pain, anaemia, joint pain, and skin problems, among others.

A 2023 study published in the journal Lancet showed that the rising urbanisation which comes with increased intake of ultra-processed foods is leading to a surge in IBD among young adults and even adolescents in India.

The study by AIG Hospitals in Hyderabad showed that about 15 lakh people in India suffer from IBD, but the true picture is not clear due to a lack of proper data.

Anukalp Prakash, Lead Consultant -- Gastroenterology, CK Birla Hospital, Gurugram, told IANS that there is also an increase in paediatric cases of IBD.

While the exact cause is not known, genetics may be at play, she said.

"The cause of inflammatory bowel disease is not known but genetics as an immunity. Alteration in immunity plays a very important role in the occurrence of inflammatory bowel disease. People who have a family history of inflammatory bowel disease are vulnerable to developing inflammatory bowel disease because this is a genetic disease and autoimmune disease," Anukalp added.

The Lancet study also blamed C-section deliveries that devoid the child of the essential gut microflora. Further, lack of breastfeeding and excessive use of antibiotics also increase the risk of IBD.

The health experts called for maintaining a healthy diet rich in fibre, staying hydrated, and avoiding preservatives.