Clinical spectrum of Inflammatory Bowel Disease in tertiary care centre in India

India appears to be on the epidemiological crossroadswhere infectious diseases as well as diseases hitherto considered to bediseases of the Western world are both being witnessed. Incidence andprevalence of IBD is increasing. The clinical spectrum of IBD in India islikely to be different from west because of differences in genetic andenvironmental influences. This has been partly looked into by a country-widesurvey of IBD from India. IBD in the West is characterized by a bimodal agedistribution with peaks at age groups 20–39 and 60–79 years. However the meanage at diagnosis of UC and CD was 38.5 and 35.9 years, respectively, in Indiaand is not associated with a second peak. Similarly gender distribution,disease location and behavior in India are expected to be distinct from west.The long-term disease course of Indian IBD patients including need forimmunosuppressives, biologics, surgical interventions and rates ofcomplications including colorectal carcinoma needs to be studied in detail.Malnutrition is a major complication of inflammatory bowel disease (IBD). Themain determinants of malnutrition in IBD include poor oral intake,malabsorption, chronically stimulated inflammatory cascade, gastrointestinalnutrient loss and increased energy expenditure. IBD can also alter thehomeostasis of muscles, bones, and fat leading to sarcopenia (defined as depletionin lean muscle mass coupled with a loss of muscle strength) and dysregulated body composition. Leanmass deficits have been associated with demonstrable morbidity, mortality, andreduced quality of life. Sarcopeniais common in patients with IBD and such patients have higher rates of bothsurgical interventions and postoperative complications. Other particularconcerns in IBD patients are that many of the patients are young, have activeinflammation, may be profoundly malnourished and are immunosuppressed. Despitethe risks and potential sequelae of low lean muscle mass and sarcopenia in IBD,there is a lack of high-quality data. A correct assessment of muscle mass andstrength as well as nutritional status that provides quantitative andqualitative evaluations is important and timely recognition ofsarcopenia/malnutrition may help in planning adequate and customizednutritional regimens. The presentation and spectrum of IBD has also changed inlast two decades.