The World Burden of Illness (GBD) 2019 study estimated 2,70,719 circumstances of Inflammatory Bowel Illness (IBD) in India, with an age-standardised prevalence fee of 20.34 per 100,000. This marks a dramatic rise from 1,30,000 circumstances in 1990. On the identical time, extra individuals are being recognized with ulcerative colitis, and Crohn’s illness –though usually underdiagnosed or underreported — is turning into a giant concern for public well being.
IBD, which incorporates ulcerative colitis and Crohn’s illness, is power inflammatory situations of the digestive tract. Signs similar to diarrhoea, belly ache, fatigue, and weight reduction can severely influence high quality of life.
In response to Nandish H. Okay., senior advisor gastroenterologist, Narayana Well being Metropolis, Bengaluru, any signs like power diarrhoea, blood in stool, or belly ache lasting greater than 4 weeks warrant referral to a better centre for colonoscopy and early analysis and correct counselling are key to managing issues and bettering outcomes.
IBD care challenges in India
In response to the authors of a current Lancetstudy titled ‘Growing IBD counsellors in low- and middle-income nations: bridging gaps in affected person care,’ hospital-based research affirm a surge in ulcerative colitis — a sort of IBD that causes irritation and ulcers within the massive gut (colon) and rectum, circumstances in India.
Crohn’s illness, a sort of IBD that may have an effect on any a part of the digestive tract, from the mouth to the anus although less-frequently documented, is commonly misdiagnosed because of lack of expertise and restricted infrastructure.
By 2025, the nation is projected to have solely 4,200 gastroenterologists for a inhabitants of 1.45 billion — roughly 0.29 gastroenterologists per 1,00,000 folks. As compared, the USA had 3.9 gastroenterologists per 1,00,000 folks as early as 2007 — over 13 instances increased than the present projected ratio.
This scarcity results in rushed consultations, delayed diagnoses, and insufficient time for affected person schooling. Many IBD circumstances are mistaken for irritable bowel syndrome or infections, leading to inappropriate therapies.
Dr. Nandish additionally explains that misinformation round dietary triggers and remedy choices additional complicates illness administration and causes emotional misery for sufferers and households.
Do Western fashions fall brief and why?
India’s present scientific protocols usually mirror Western fashions that emphasise particular person autonomy in decision-making. Nonetheless, these approaches don’t all the time resonate within the Indian context, the place healthcare choices are sometimes made collectively inside households.
Arshia Bhardwaj, senior resident, division of Gastroenterology, Dayanand Medical Faculty, Ludhiana, and co-author of the Lancet research explains, “In India, IBD care isn’t just concerning the particular person. Members of the family — dad and mom, siblings, even kids — affect medical decisions. We’ve had sufferers decline biologics (a type of remedy) as a result of a member of the family objected.” With out acknowledging this cultural dynamic, healthcare supply stays incomplete.
Time constraints, language boundaries, and an absence of culturally nuanced communication contribute to a disconnect between docs and sufferers. “Many consider IBD is brought on by meals or stress. With out time to debunk these myths, we lose affected person belief,” says Dr. Bhardwaj.
Want for IBD care counsellors in India
To bridge these gaps, consultants advocate for the introduction of IBD counsellors — healthcare professionals educated particularly within the medical, psychological, dietary, and social dimensions of IBD in India. Not like normal counsellors or nurses, IBD counsellors would work carefully with docs and households, offering constant, culturally acceptable help.
“These counsellors might be sport changers,” says Arshdeep Singh , affiliate professor, Division of Gastroenterology, Dayanand Medical Faculty, Ludhiana and co-author. “They’ll clarify remedy plans, deal with fears about remedy, supply fundamental dietary steerage, and supply emotional help in a approach busy docs usually can’t,” Dr. Singh says.
IBD counsellors also can play an important position in dismantling stigma, correcting misinformation, and guaranteeing follow-up care — particularly in rural and semi-urban areas the place entry to specialists is minimal and conventional beliefs usually dominate
Deal with culturally delicate options
Speaking concerning the steps from analysis to remedy, Dr. Bhardwaj additionally emphasises the necessity for specialised care. She notes that whereas colonoscopy is an important diagnostic instrument, it’s not the one one — and with out correct interpretation and follow-up by specialists educated in IBD, many sufferers stay confused or misinformed about their situation. And so, given the pressure on India’s healthcare system, coaching IBD counsellors presents a scalable and cost-effective resolution.
Speaking about funding and calling for a stand-alone nationwide IBD programme, the authors additionally notes that this modification could be gradual and affected person centric. “This isn’t about constructing extra hospitals in a single day,” Dr. Bhardwaj explains. “It’s about redesigning what already exists. If even one particular person in every clinic can tackle this position, outcomes might enhance dramatically.”
The thought is to create a help system that respects India’s distinctive cultural material whereas addressing the complexities of power illness care. With the variety of normal practitioners declining and tertiary facilities overwhelmed, the IBD counsellor might change into a vital hyperlink in India’s healthcare chain — in most areas throughout the nation.
Printed – Might 06, 2025 08:12 pm IST
