Inflammatory bowel disease and African Americans: A systematic review
Article first published online: 11 FEB 2008
Copyright © 2008 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
Volume 14, Issue 7, pages 960–967, July 2008
How to Cite
Mahid, S. S., Mulhall, A. M., Gholson, R. D., Eichenberger, M. R. and Galandiuk, S. (2008), Inflammatory bowel disease and African Americans: A systematic review. Inflamm Bowel Dis, 14: 960–967. doi: 10.1002/ibd.20389
- Issue published online: 6 JUN 2008
- Article first published online: 11 FEB 2008
- Manuscript Accepted: 14 DEC 2007
- Manuscript Received: 10 JUL 2007
- John W. and Caroline Price Trust
- African Americans;
- inflammatory bowel disease;
- Crohn's disease;
- ulcerative colitis;
- extraintestinal manifestations;
- Montreal classification
Background: Inflammatory bowel disease (IBD) is comprised of Crohn's disease (CD) and ulcerative colitis (UC). There are conflicting reports on whether African Americans have a more severe disease course, presentation, and more frequent extraintestinal manifestations (EIM). We examined the precise nature of this relationship by conducting a systematic review.
Methods: Using predefined inclusion criteria we searched multiple healthcare databases and Grey literature. Eight reports met the inclusion criteria. Using the parameters as defined in the Montreal classification and the presence or absence of EIM, we compared IBD in African Americans and Caucasians.
Results: Over 2000 IBD cases were pooled from 8 reports with African Americans comprising 17%. African Americans and Caucasians had similar distribution of types of IBD, with CD being more common than UC in both groups (CD 76% versus 68% and UC 24% versus 32%, respectively). With respect to CD, both groups presented with nonstricturing and nonpenetrating disease behavior (55% versus 41%) more frequently and had similar rates of ileocolonic disease location (42% versus 38%), and presence of perianal disease (26% versus 29%). In UC patients, proctitis was the most frequent initial presentation in both races. Joint complications were the most frequent EIM in both African Americans (52%) and Caucasians (60%).
Conclusions: This study dispels the commonly held views that African Americans with IBD generally have more colonic disease, more severe disease behavior, and more perianal disease than Caucasians. African Americans also have similar variety and frequency of EIMs as compared to Caucasians.
(Inflamm Bowel Dis 2008)