title: Hispanics and inflammatory bowel disease.
abstract: BACKGROUND
  Historically, inflammatory bowel disease (IBD) was considered a disease, which predominately affects whites. As such, the majority of research in IBD has been conducted in this population. However, more research on this suggests that IBD affects other ethnic groups. Rapidly shifting demographics in the United States necessitates a better understanding of how IBD may affect Hispanics. We reviewed the current literature on IBD in Hispanics.
  
  
  METHODS
  A PubMed search was conducted using keywords inflammatory bowel disease, Ulcerative Colitis, Crohn's disease, Hispanics, Latinos, ethnicity, to identify existing literature with a focus on adult populations. Non-English language articles were excluded.
  
  
  RESULTS
  The existing data and literature on Hispanic patients with IBD remains sparse. Limited studies on prevalence suggest IBD may be more common in Hispanics in the United States compared with those in Latin America. Conflicting data exist as to whether Hispanics patients with IBD are more likely to have ulcerative colitis compared with Crohn's disease. One study explored difference in IBD between foreign-born and U.S.-born Hispanics and found that ulcerative colitis was more common only in foreign-born Hispanics, whereas within 1 generation, U.S.-born Hispanics resemble their non-Hispanic white counterparts about development of Crohn's disease. Such a rapid change in the proportion of ulcerative colitis and Crohn's disease points strongly to environmental factors driving the change in proportion of disease subtypes. Additionally, a trend towards less use of biologic and immunomodulators in Hispanics was noted in several studies.
  
  
  CONCLUSIONS
  Additional research is needed to better understand how diversity within the Hispanic population (U.S.-born and foreign-born) may be driving difference in disease manifestations. More investigations should focus on determining the cause of a potential disparity in the use of biologic and immunomodulators in Hispanics.
authors.affiliation: Department of Medicine, Division of Gastroenterology, George Washington University, Washington, DC.
authors.forename: Lakshmi D N
authors.initials: LD
authors.lastname: Lattimer
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Chandler
authors.forename: Marie L
authors.initials: ML
authors.lastname: Borum
mesh_terms: D000328:Adult; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000208:ethnology*; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index