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Second-highest bowel disease burden in the world

Around 1.5 million people are affected by inflammatory bowel disease (IBD) in India — the second-highest disease burden in the world outside of the United States.

The findings were uncovered by a study carried out by Wellness 365, a community representing Indian medical professionals and practitioners. Rates of IBD were found to be rising steadily, marking the possibility that India eventually becomes the single highest burden country, as the US is only marginally ahead at 1.6 million.

The study results come on the heel of World IBD Day 2020, observed on May 19th. Wellness 365 have announced the month-long #ManageYourIBD campaign to raise awareness of the condition and to help those suffering from the condition to avail the appropriate medical intervention.

“Medical management remains the key modality in the treatment of inflammatory bowel disease. In case of ulcerative colitis, the need for surgical intervention is low at about six percent for Indian patients while the worldwide average being about ten-twelve percent.” said Dr Ajay Bhalla, Director and Head Gastroenterology at Fortis Hospital, Noida. “Medical management with drugs like 5-ASAs, steroids and azathioprines and use of biologics gives effective outcomes.

“However, in [the] case of Crohn’s disease, the patient can end up with conditions like intestinal crystallisation or recurrent obstruction, where surgery may be required. It is seen worldwide and in India too that about one third of patients with Crohn’s disease require surgery at some point of time.”

Conditions such as ulcerative colitis and Crohn’s disease are lifelong conditions that often require significant amounts of medical intervention in addition to constant use of drugs to reduce inflammation. Such conditions can often leave users paying the costs out-of-pocket.

In 2014, 65.6 percent of healthcare costs in India were borne by patients out-of-pocket though more recent data suggests a percentage closer to eighty percent. Many, as a result, are driven to poverty. 

While schemes such as Ayushman Bharat alleviate this out-of-pocket expenditure to a degree, the scheme only covers for up to five lakh per family per year. This amount is substantial. However, with the potential for frequent surgery in addition to medication year-round, a single individual with a chronic bowel disease could feasibly go over this amount within a year.

Given that a lack of treatment for these conditions can massively heighten the risk of developing colorectal cancer due to potential lifelong inflammation, more must be done to both diagnose and treat these conditions.

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