As Crohn’s and Colitis awareness week begins, doctors across India are urging the public to recognise the growing burden of Inflammatory Bowel Disease (IBD), a group of chronic, lifelong conditions that includes Crohn’s disease and ulcerative colitis. Though traditionally considered rare, IBD is now being detected in India with increasing frequency, especially among adolescents and young adults.
It is often called the ‘invisible illness,’ with symptoms such as abdominal pain, diarrhoea, rectal bleeding, fatigue, weight loss, most of which do not always show on the outside. But for patients, the illness can reshape their daily lives. “People look at me and say, ‘But you don’t look sick.’ What they don’t see is how I plan my entire day around restrooms, or how I lie awake at night wondering when the next flare-up will hit. Crohn’s is invisible, but it dictates everything, from what I eat to where I go,” says Sakshi Pilani (name changed), a young professional, tells Buzz.
Doctors say IBD cases in India are rising, but awareness remains disproportionately low. Many patients spend years in misdiagnosis, often treated for acidity, IBS, food poisoning, or stress, before reaching a gastroenterologist. “Most of our patients come to us after years of being treated for acidity, irritable bowel syndrome, or infections. By the time Crohn’s or colitis is finally considered, the disease has often progressed. Early referral to a gastroenterologist is crucial, but awareness at the primary-care level is still far too low,” says Dr Anupam Sibal, group medical director, Apollo Hospitals.
“By the time some patients come to us, the disease has advanced significantly,” says, explaining how delayed treatment can lead to strictures, anaemia, fistulas, and even the need for surgery.
Challenges:
India still faces major affordability barriers. Biologics, the drugs that transformed IBD care globally, remain out of reach for the average family without insurance support. Patient groups have long argued that the lack of insurance coverage or reimbursement schemes forces families to choose between long-term health and financial strain.
“My doctor recommended biologics, but the cost was more than my monthly salary. It really is tragic when you know that the treatment exists, but you just cannot afford it. Chronic illness shouldn’t become a financial punishment,” says Pilani.
The past decade has seen more teenagers and young adults diagnosed with IBD in India. For students, flare-ups can interrupt exams, attendance, and mental well-being.
Children with IBD may also struggle with growth, nutrition, and stigma around toilet access. Parents often describe feeling helpless when navigating a disease that is not commonly discussed.
Even with treatment, patients need flexibility, restroom access, modified schedules during flare-ups, and elimination of stigma. IBD support groups say that while awareness is improving, India still lacks school guidelines or workplace policies to accommodate chronic conditions like IBD.
Between January 2014 and December 2015, a nationwide multi center, cross-sectional, registry was established across four geographical zones of India on inflammatory bowel disease. Adult patients with ulcerative Colitis and Crohn’s disease were enrolled and information related to demographics, disease features, complications, and treatment history was collected and analysed.
The study found that ulcerative colitis far outnumbered Crohn’s disease, with roughly five times more UC cases than CD. Patients were typically diagnosed in young adulthood, with an average age of around 37, and men were diagnosed more often than women in this cohort.
There are striking regional differences too, with UC concentrated in northern centres, while CD was relatively more common in southern centres, thereby suggesting environmental or population-level factors. It was also found that despite advances in therapy, very few patients in the registry received biologic drugs, underscoring access and affordability barriers.
Clinicians say this awareness week should be a reminder that early diagnosis and continued care can allow most patients to live full, active lives. What’s needed is public education, insurance reform, and stronger support systems. As India pays more attention to non-communicable diseases and long-term health conditions, this is a moment to bring IBD out of the shadows and into mainstream health conversations.
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