Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). The other type of IBD is Crohn’s disease. Discussing bowel disorders is not always a simple conversation, particularly when discussing racial disparities in the treatment of these disorders. A 2016 study, published by the journal Inflammatory Bowel Disease, discovered that in the past 20 years, IBD is on the increase in minority groups in the U.S.
Racial disparity in treatment of ulcerative colitis
The 2016 Inflammatory Bowel Disease journal study examined study results from over 40 past clinical research studies and found that Blacks with inflammatory bowel disease received different treatment than whites, including:
- Blacks were 25 to 50% less likely than Caucasians to undergo a surgical procedure called a colectomy for ulcerative colitis
- Minorities with Crohn’s disease were 30 to 70% less likely to have bowel surgery (resection) than Caucasians
- Blacks lacked access to specialized healthcare providers, affordable healthcare, and accommodations at work, resulting in disproportionately suffering pain and discomfort, compared to Caucasians
- Blacks experienced a higher rate of complications after surgery (including a higher incidence of sepsis (an infection in the blood) compared to other racial groups
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Common Myths
There are many common myths surrounding inflammatory bowel disease—including ulcerative colitis and Crohn’s disease— that minorities and other racial groups have adopted.
Myth #1 Blacks and Other Minorities Are Not at High Risk of IBD
A person of any racial group or ethnic background can be diagnosed with Crohn's disease and ulcerative colitis. The disease was once considered a condition that only affected European populations, but research demonstrates that minorities are also at risk.
Blacks are thought to have a slightly lower risk of IBD than white Americans, according to a 2016 study published in the journal Gastroenterology. However, Blacks are still at a significant risk for UC and other GI (gastrointestinal) conditions.
A study published by the Journal of Inflammatory Bowel Disease reported that there was a higher prevalence of ulcerative colitis among Hispanics than among Caucasians, and Crohn's disease is causing more hospitalizations among the Asian population.
Myth #2 IBD is Embarrassing, it Should Be Kept Secret
A diagnosis of IBD can be considered taboo in some cultures. This often evolves from a societal stigma surrounding being diagnosed with a chronic disorder, such as ulcerative colitis.
Often the stigma of a disorder like IBD is associated with a belief that it’s best to keep the disorder secret. IBD may require multiple surgeries, resulting in the need for an ostomy bag.
There are support communities aimed at helping people with IBD manage their condition and cope with the emotions and misdirected feelings, such as shame, that often accompany the disorder.
Myth #3 IBD Is Caused by Depression, Anxiety, or Emotional Stress
IBD is a biological condition, not a psychological one. Historically, IBD was considered one of several medical disorders caused by certain personality traits. Recent research does not support this theory.
Researchers have determined that substituting mental health treatment, such as individual therapy, for medical treatment may worsen ulcerative colitis symptoms. Although medical research does not show that stress or depression causes IBD, stress and depression, which occur more frequently in minority populations—can worsen symptoms and interfere with managing the disease, according to a 2018 study published in the journal Preventative Medicine.
Just as with any other chronic (long-term) disease, IBD can affect a person’s mental health. Many people with IBD will suffer at least one bout of major depression, which is often centered on the need for surgery that results in the need for a colostomy bag.
Having anxiety, insomnia, or a high level of stress can negatively affect disorders linked with inflammation, often exacerbating (worsening) symptoms. Commonly, people with ulcerative colitis or Crohn's disease find that living one day at a time and employing measures for relaxation (e.g., yoga or meditation) really helps to cope with the daily impact of the disease.
RELATED: How To Manage Ulcerative Colitis
Myth #4 Alternative Medicine is Better Than Prescriptions for IBD
Although alternative therapies, such as supplements or dietary changes, might seem right for you to start your treatment with, your doctor will provide you with medical treatment aimed at addressing your symptoms and diagnosis. Eating the right foods and maintaining a healthy IBD diet and nutrition is part of a healthy regime for IBD. But there is much more to effective treatment than simply changing your diet.
It may be helpful to speak with your healthcare provider about the possibility of combining certain alternative treatment options with traditional ulcerative colitis treatment. This way, you won’t delay the start of medical treatment that is proven effective. It’s essential to hold off on taking any type of natural or herbal supplement (including over-the-counter vitamins) until you speak with your gastroenterologist (a doctor who specializes in treating intestinal and stomach disorders). The same goes for holistic therapies such as acupuncture or homeopathic treatment.
Myth #5: You Are Alone in Having IBD
It’s common for people to feel they are alone with any type of chronic disease. This can contribute to myths and fears surrounding ulcerative colitis. IBD patients can feel as if the odds are stacked against them, whether it's cultural shame, chronic illness stigma, body image, or mental health issues.
Seeking help and support from others with IBD, including minority support groups, can ensure that you are, in fact, not alone in having the disorder. The Crohn’s and Colitis Foundation offers education and support for people with IBD. You can find tips on employing mental and emotional support on their website.