Inflammatory bowel disease in kashmir valley

Background: Last decade has shown increase in IBD cases from Asian countries which is against the belief that IBD is very rare in developing Asian countries including Kashmir valley. There is no study done in Kashmir valley on Inflammatory Bowel Disease. Objective: To study Clinicopathological profile of IBD patients in Kashmiri population where this disease has not been studied till now. Material and Methods: 5 years study extending from June 2009 to June 2014, prospective for two years and retrospective for three years. Biopsies and resected specimen received were studied in detail. Results: Study included total of 210 IBD cases. Males were 127 (60.5%) and 83 (39.5%) were females. M:F ratio was 1.53:1. Age ranged from 1 to 80 years, Mean Age was 39.75 years. Maximum number of cases were seen in age group of 20 to 30 years (23.33%). Smoking history was absent in 79%. History of junkfood and fast food consumption was present in most IBD patients. 75.5% were residing in urban areas. IBD was more common in Educated and Middle socioeconomic class. Pain abdomen, bloody diarrhoea and Hematochesia were dominant symptoms. Arthritis was present in 4 patients. Mean duration of disease was 2.43 years. Haemorrhagic areas, ulcerated and friable areas, loss of vascularity and oedema were dominant endoscopic findings. Rectum was involved in 119 and sigmoid colon in 84 patients. Cryptitis, mucodepletion, cryptabscesses, crypt distortion, cryptatrophy and epithelial erosions were dominant microscopic findings. Out of total 210 IBD patients UC was present in 86.6%, CD in 12.38% and Indeterminate colitis in 2 patients. Granulomas and fissures were present in 9 CD Patients. All CD and Indeterminate colitis patients were negative for Dysplasia, out of 182 UC patients low grade dysplasia was present in 17 and high grade dyplasia in 4 patients. Conclusion: IBD is no longer a western disease only. This study confirms the existence of IBD in this geographical area and emphasises the need of studying IBD in detail in this geographical area and increasing awareness about this disease by educating health care providers and patients about this disease and encourage periodic endoscopic surveillance biopsies to rule out dysplasia.