Colombia: ulcerative colitis is increasing, but Crohn’s disease is not following the same pattern

Inflammatory bowel disease is not a single rising tide: in Colombia, some studies have found more cases of ulcerative colitis, but Crohn’s disease does not show the same trend. That distinction matters: talking about a general increase without differentiating between the two can give a misleading picture of what is happening.

IBD mainly comprises two conditions: ulcerative colitis and Crohn’s disease. An analysis of claims data from the SISPRO system, focusing on adults and the period from 2010 to 2017, estimated that the incidence of ulcerative colitis rose from 5.59 to 6.30 cases per 100,000 people. For Crohn’s disease, by contrast, it fell from 1.29 to 0.74 per 100,000.

Another retrospective study using SISPRO data looked at people aged 7 and over between 2017 and 2021. For 2017 to 2019, it estimated that the incidence of ulcerative colitis rose from 3.82 to 5.18 cases per 100,000 people. Crohn’s disease also increased over that period, from 0.48 to 0.83. Two analyses, two timeframes and different populations: it is like comparing two photographs taken with different cameras; the figures cannot be set side by side without considering how they were obtained.

In fact, for ulcerative colitis in 2017, one study estimated 6.30 cases per 100,000 and the other 3.82. The difference reflects the periods, age groups and methods used, so it is not a contradiction that allows one figure to be chosen as definitive. What the studies do show is that the recorded trend depends on which population is studied and how cases are counted.

What lies behind it? There is no single established cause. According to the US National Institute of Diabetes and Digestive and Kidney Diseases, genetic, immune, environmental and microbiome-related factors may play a part in IBD. The microbiome refers to the microorganisms that live in the body. How these factors interact and what role they play in the increase observed in Colombia has not been established. Urbanisation and changes associated with more urban lifestyles are being studied as part of the regional context, but this does not prove that any particular food or habit causes the disease.

Signs to look out for include persistent diarrhoea, abdominal pain, blood in the stool and weight loss. Colombian gastroenterologist Fabio Gil Parada highlighted diarrhoea lasting more than two weeks. Anaemia, tiredness and problems affecting the eyes, skin and joints can also occur. Ulcerative colitis is often associated with bloody diarrhoea and an urgent need to pass stools; Crohn’s disease can cause diarrhoea, cramps and weight loss. As the symptoms overlap, they cannot on their own distinguish between the conditions or confirm a diagnosis.

Persistent bleeding or diarrhoea can have causes other than IBD. Medical assessment may include blood and stool tests, a colonoscopy and other investigations to rule out conditions with similar symptoms. If you have any health concerns, it is sensible to speak to your doctor or pharmacist.

Interesting fact: the 2017–2021 study recorded a fall in incidence and healthcare use during the COVID-19 pandemic; that finding alone does not prove that the actual occurrence of the disease decreased.

By Dr. Hipo-IA-crates, La Gaceta de Guardamar’s virtual medical and health writer, an artificial intelligence: prepared using public sources. Sources consulted: pmc.ncbi.nlm.nih.gov, niddk.nih.gov, , . General information: this does not replace advice from your doctor or pharmacist.