Causes of Inflammatory Bowel Disease (IBD): From antibiotics to urban diets, here's what causes unexplained gut symptoms

Symptoms of Inflammatory Bowel Diseases (IBD): Symptoms of IBD include diarrhoea, weight loss, abdominal pain, which often resemble those of more common issues like irritable bowel syndrome or even intestinal tuberculosis (Image: Canva)

Inflammatory Bowel Disease (IBD), including ulcerative colitis and Crohn’s disease, has seen a dramatic rise in India, over the past two decades. The condition, marked by chronic inflammation of the digestive tract, is not just an urban issue anymore; it’s fast becoming a nationwide health concern. Experts warn that factors like environment, dietary, and healthcare, are driving this silent epidemic.

A 2023 study by the IBD Center of the Asian Institute of Gastroenterology in Hyderabad found that IBD prevalence rose from 0.1 percent in 2006 to over 5 percent by 2022. While initially assumed to be limited to cities, newer data indicates that rural areas are catching up.

"India is witnessing a rapid increase in IBD cases, especially in urban centres," says Dr Sharad Malhotra, Senior Consultant at Aakash Healthcare, Delhi. "This is largely due to the shift from traditional diets high in fibre and natural foods to processed, Western-style meals filled with saturated fats and sugars. It’s changing your gut microbiome and weakening your intestinal defences," Dr Malhotra says.

Also read | Causes of irritable bowel syndrome: Can caffeine in tea and coffee trigger IBS?

Additionally, widespread antibiotic use in early childhood is adding to the risk. Says Dr Sunil Rana from Asian Hospital, Faridabad shares, “Antibiotic exposure during critical growth years disrupts the gut flora. This imbalance, known as dysbiosis, has strong links to IBD development later in life.”

Here’s what you need to know:

• Symptoms can be misleading: IBD symptoms including, diarrhoea, weight loss, abdominal pain, often resemble those of more common issues like irritable bowel syndrome or even intestinal tuberculosis. "The overlapping nature of symptoms makes diagnosis incredibly tricky," says Dr Suhas Udgirkar, Jupiter Hospital, Pune.

• Misdiagnosis can be dangerous: In India, IBD is frequently mistaken for intestinal TB. “Histopathological distinction between the two is critical,” explains Dr Udgirkar. He adds, “Incorrect treatment can worsen outcomes and delay proper care.”

• Diagnostics are still metro-centric: “There's no single test to confirm IBD,” says Dr Aakaar Kapoor, City XRay and Scan Clinic, Delhi. “Diagnosis involves a mix of lab work, endoscopy, and clinical evaluation, tools often unavailable outside major cities,” he says.

• Awareness is alarmingly low: Many patients delay seeking help due to cultural stigma and lack of knowledge. “People often feel too embarrassed to talk about digestive issues,” informs Dr Malhotra. “But silence can be costly.”