Inflammatory bowel disease in Jamaica

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.