Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is increasingly recognized in South Asia and among its diaspora, including migrant populations. South Asian patients more often exhibit fistulizing and perianal Crohn’s disease, and sarcopenia is more prevalent in active disease. Vegetarianism is common, and plant-based fiber supports symptom and inflammation control, though adherence can be challenging. Self-imposed restrictions on dairy, spicy, or fatty foods are widely reported. Micronutrient deficiencies—particularly vitamin D, iron, and zinc—and psychosocial concerns, including anxiety, depression, post-traumatic stress disorder, and caregiver burden, are frequent. These factors highlight the need for culturally sensitive, interdisciplinary care.

    1. Chedid V, Targownik L, Damas OM, Balzora S. Culturally sensitive and inclusive IBD care. Clin Gastroenterol Hepatol. 2025;23(3):440-453.

      View Article: doi:10.1016/j.cgh.2024.06.052

    2. Mukherjee S, Beresford B, Atkin K, Sebastian S. The need for culturally competent care within gastroenterology services: Evidence from research with adults of South Asian origin living with inflammatory bowel disease. J Crohns Colitis. 2021;15(1):14-23.

      View Article: doi: 10.1093/ecco-jcc/jjaa117

    3. Agrawal M, Burisch J, Colombel JF, Shah SC. Viewpoint: inflammatory bowel diseases among immigrants from low- to high-incidence countries: opportunities and considerations. J Crohns Colitis. 2020;14(2):267-273.

      View Article: doi:10.1093/ecco-jcc/jjz139

    1. Giri S, Jena A, Kumar-M P, Muniswamy JR, Nath P, Sharma V. Burden of inflammatory bowel disease in India: analysis of the Global Burden of Disease study from 1990 to 2019. Intest Res. 2026;24(1):84-94.

      View Article: doi:10.5217/ir.2024.00134

    2. Shenoy S, Jena A, Levinson C, et al. Inflammatory bowel disease in south Asia: a scoping review. Lancet Gastroenterol Hepatol. 2025;10(3):259-274.

      View Article: doi:10.1016/s2468-1253(24)00341-8

    3. Ibrahim MK, Cohen R, Chhibba T, et al. An international multicenter study of native and immigrant South Asian Crohn's disease. Clin Gastroenterol Hepatol.

      View Article: doi:10.1016/j.cgh.2025.06.022

    4. Shankar S, Majumder S, Mukherjee S, et al. Inflammatory bowel disease: a narrative review of disease evolution in South Asia and India over the last decade. Therap Adv Gastroenterol. 2024;17:17562848241258360.

      View Article: doi:10.1177/17562848241258360

    5. Rajasekaran V, Evans HM, Andrews A, et al. Rising incidence of inflammatory bowel disease in South Asian children in New Zealand: a retrospective population-based study. J Pediatr Gastroenterol Nutr. 2023;76(6):749-755.

      View Article: doi:10.1097/mpg.0000000000003735

    6. Sood A, Kaur K, Singh A, Midha V, Mahajan R, Bansal N, et al. Trends of inflammatory bowel disease at a tertiary care center in northern India. Intest Res. 2021;19(3):282-290.

      View Article: doi:10.5217/ir.2020.00010

    7. Srivastava A, Sathiyasekharan M, Jagadisan B, et al. Paediatric inflammatory bowel disease in India: a prospective multicentre study. Eur J Gastroenterol Hepatol. 2020;32(10):1305-1311.

      View Article: doi:10.1097/meg.0000000000001859

    8. Amarapurkar AD, Amarapurkar DN, Rathi P, et al. Risk factors for inflammatory bowel disease: a prospective multi-center study. Indian J Gastroenterol. 2018;37(3):189-195.

      View Article: doi:10.1007/s12664-018-0850-0

    1. Balarajah S, Martinez-Gili L, Alexander JL, et al. Diverse phenotypes, consistent treatment: a study of 30 997 South Asian and White inflammatory bowel disease patients using the UK inflammatory bowel disease BioResource. J Crohns Colitis. 2025;19(1):jjae186.

      View Article: doi:10.1093/ecco-jcc/jjae186

    2. Dhaliwal J, Carroll MW, deBruyn JC, et al. The phenotypic spectrum of new-onset IBD in Canadian children of South Asian ethnicity: a prospective multicentre comparative study. J Crohns Colitis. 2022;16(2):216-223.

      View Article: doi:10.1093/ecco-jcc/jjab143

    3. Bodiwala V, Marshall T, Das KM, Brant SR, Seril DN. Comparison of disease phenotypes and clinical characteristics among South Asian and White patients with inflammatory bowel disease at a tertiary referral center. Inflamm Bowel Dis. 2020;26(12):1869-1877.

      View Article: doi:10.1093/ibd/izaa019

    4. Jangi S, Ruan A, Korzenik J, de Silva P. South Asian patients with inflammatory bowel disease in the United States demonstrate more fistulizing and perianal Crohn phenotype. Inflamm Bowel Dis. 2020;26(12):1933-1942.

      View Article: doi:10.1093/ibd/izaa029

    5. Banerjee R, Pal P, Nugent Z, et al. IBD in India: similar phenotype but different demographics than the West. J Clin Gastroenterol. 2020;54(8):725-732.

      View Article: doi:10.1097/mcg.0000000000001282

    6. Kalaria R, Desai D, Abraham P, Joshi A, Gupta T, Shah S. Temporal change in phenotypic behaviour in patients with Crohn's disease: do Indian patients behave differently from Western and other Asian patients? J Crohns Colitis. 2016;10(3):255-261.

      View Article: doi:0.1093/ecco-jcc/jjv202

    7. Carroll MW, Hamilton Z, Gill H, et al. Pediatric inflammatory bowel disease among South Asians living in British Columbia, Canada: a distinct clinical phenotype. Inflamm Bowel Dis. 2016;22(2):387-396.

      View Article: doi:10.1097/mib.0000000000000651

    1. Sahni N, Rana U, Rajan S, et al. Dietary behaviour, attitude and food perceptions of patients with ulcerative colitis - An observational study. J R Coll Physicians Edinb. 2024;54(3):212-220.

      View Article: doi:10.1177/14782715241281682

    2. Sigall Boneh R, Park S, Soledad Arcucci M, et al. Cultural perspectives on the efficacy and adoption of the Crohn's disease exclusion diet across diverse ethnicities: A Case-based overview. Nutrients. 2024;16(18):3184. 

      View Article: doi:10.3390/nu16183184

    3. Kedia S, Virmani S, K Vuyyuru S, et al. Faecal microbiota transplantation with anti-inflammatory diet (FMT-AID) followed by anti-inflammatory diet alone is effective in inducing and maintaining remission over 1 year in mild to moderate ulcerative colitis: a randomised controlled trial. Gut. 2022;71(12):2401-2413.

      View Article: doi:10.1136/gutjnl-2022-327811

    4. Negm M, Bahaa A, Farrag A, et al. Effect of Ramadan intermittent fasting on inflammatory markers, disease severity, depression, and quality of life in patients with inflammatory bowel diseases: A prospective cohort study. BMC Gastroenterol. 2022;22(1):203. 

      View Article: doi:10.1186/s12876-022-02272-3

    5. Crooks B, Misra R, Arebi N, et al. The dietary practices and beliefs of British South Asian people living with inflammatory bowel disease: a multicenter study from the United Kingdom. Intest Res. 2022;20(1):53-63.

      View Article: doi:10.5217/ir.2020.00079

    6. Tomar SK, Kedia S, Upadhyay AD, et al. Impact of dietary beliefs and practices on patients with inflammatory bowel disease: An observational study from India. JGH Open. 2017;1(1):15-21.

      View Article: doi:10.1002/jgh3.12002

    1. Sharma S, Gupta A, Kedia S, et al. Efficacy and tolerability of exclusive enteral nutrition in adult patients with complicated Crohn's disease. Intest Res. 2021;19(3):291-300.

      View Article: doi:10.5217/ir.2019.09172

    2. Sahu P, Kedia S, Vuyyuru SK, et al. Randomised clinical trial: exclusive enteral nutrition versus standard of care for acute severe ulcerative colitis. Aliment Pharmacol Ther. 2021;53(5):568-576.

      View Article: doi:10.1111/apt.16249

    3. Sood A, Singh A, Sudhakar R, et al. Exclusive enteral nutrition for induction of remission in anti-tumor necrosis factor refractory adult Crohn's disease: the Indian experience. Intest Res. 2020;18(2):184-191.

      View Article: doi:10.5217/ir.2019.00094

    1. Farooq A, Anjum J, Zafar T, et al. Frequency of folate and vitamin B12 deficiency among patients with Crohn's disease. Indus J Biosci Res. 2025;3(4):1087-1091.

      View Article: doi:10.70749/ijbr.v3i4.2435

    2. Sachan A, Thungapathra M, Kaur H, et al. Comprehensive assessment of nutritional and functional status of patients with ulcerative colitis and their impact on quality of life. Indian J Gastroenterol. 2024;43(1):254-263. 

      View Article: doi:10.1007/s12664-024-01539-9

    3. Singh A, Midha V, Mahajan R, et al. Evaluation of nutritional characteristics reveals similar prevalence of malnutrition in patients with ulcerative colitis and Crohn's disease. Dig Dis Sci. 2023;68(2):580-595.

      View Article: doi:10.1007/s10620-022-07652-z

    4. Law AD, Dutta U, Kochhar R, et al. Vitamin D deficiency in adult patients with ulcerative colitis: Prevalence and relationship with disease severity, extent, and duration. Indian J Gastroenterol. 2019;38(1):6-14.

      View Article: doi:10.1007/s12664-019-00932-z

    5. Chaubal A, Pandey V, Choksi D, et al. Anemia in patients with ulcerative colitis in remission: A study from western India. Indian J Gastroenterol. 2017;36(5):361-365. 

      View Article: doi:10.1007/s12664-017-0791-z

    1. Dharap V, Desai D, Abraham P, et al. Prevalence and outcome of sarcopenia in patients with inflammatory bowel disease: a follow-up study. Intest Res. 2026;24(1):141-150.

      View Article: doi:10.5217/ir.2024.00096

    2. Neelam PB, Pal R, Gupta P, et al. Sarcopenia is common in ulcerative colitis and correlates with disease activity. Intest Res. 2024;22(2):162-171.

      View Article: doi:10.5217/ir.2023.00090

    3. Yadav DP, Kedia S, Madhusudhan KS, et al. Body composition in Crohn's disease and ulcerative colitis: Correlation with disease severity and duration. Can J Gastroenterol Hepatol. 2017;2017:1215035.

      View Article: doi:10.1155/2017/1215035

    1. Sharma B, Sharma N, Bodh V, Sharma R, Sharma V, Kumar R. Metabolic bone disease in ulcerative colitis: a cross-sectional study in a tertiary care hospital of Northern India. CHRISMED J Health Res. 2022;9(3):154-158.

      View Article: doi:10.4103/cjhr.cjhr_136_21

    1. Banerjee R, Pal P, Hilmi I, et al. Primary caregiver burden and undiagnosed mental health illness in out-patients with inflammatory bowel disease-A multicentric prospective survey from the IBD Emerging Nations' Consortium. Indian J Gastroenterol. 2024;43(6):1156-1167.

      View Article: doi:10.1007/s12664-024-01617-y

    2. Singh A, Bhardwaj A, Tripathi A, Ranjan MK, Singh D, Sachdeva A, et al. Burden of anxiety, depression and perceived stress in patients with inflammatory bowel disease: a cohort study from North India. Dig Dis Sci. 2024;69(3):775-790.

      View Article: doi:10.1007/s10620-023-08242-3

    3. Aswani-Omprakash T, Balasubramaniam M, McGarva J, et al. Post-traumatic stress disorder symptoms are frequent among inflammatory bowel disease patients of South Asian descent-A case-control study. Indian J Gastroenterol. 2024;43(1):244-253.

      View Article: doi:10.1007/s12664-023-01424-x

    1. Aswani-Omprakash T, Shah ND. Sociocultural considerations for food-related quality of life in inflammatory bowel disease. Gastroenterol Clin North Am. 2022;51(4):885-895.

      View Article: doi:10.1016/j.gtc.2022.07.013

    2. Subasinghe D, Navarathna NM, Samarasekera DN. Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia. World J Gastrointest Pharmacol Ther. 2016;7(3):447-452.

      View Article: doi:10.4292/wjgpt.v7.i3.447

Previous

Fatty Liver Disease
Next

Irritable Bowel Syndrome