Inflammatory bowel disease in Jamaica

Abstract

Background Although inflammatory bowel disease (IBD) has been reported worldwide, it is primarily a disease of the developed world and most studies have reported on Caucasian populations.

Methods All IBD patients seen at the University Hospital of the West Indies, Jamaica, between January 2000 and January 2010 were reviewed.

Results There were 103 patients, 64 had ulcerative colitis (UC) and 39 Crohn's disease (CD), ratio of 1.6:1. In patients with UC there were 21 males and 42 females (M:F=0.5:1), whilst in those with CD 21 were males and 17 females (M:F=1.2:1). The mean age was 32.3 (range 2-84) years. Only 3.9% of patients were current smokers, 6.8% were past smokers. A family history of IBD was present in 7%. In CD patients, 56% had colitis only and 21% had small bowel disease. In UC patients, 31% had pancolitis, and 44% left-sided disease. The duration of disease was 5 years in 32%, 5-20 years in 54%, and more than 20 years in 14%. The main presenting features were diarrhea (93%), rectal bleeding (56%), abdominal pain (48%), weight loss (25%) and nausea and vomiting (19%). For patients with CD, presentation also included fistulas and small bowel obstruction. Extraintestinal manifestations were present in 38% of patients, and joint pain was present in 67.5% of them. Other extraintestinal manifestations were primary sclerosing cholangitis in 20% and pyoderma gangrenosum in 15%.

Conclusion IBD is relatively uncommon in Jamaica. UC is more common than CD. Most cases of CD had colitis only. The clinical features and outcome are similar to other reports.

Keywords Inflammatory bowel disease, ulcerative colitis, Crohn's disease, Jamaica