Inflammatory Bowel Disease, a Rare or Under Diagnosed Disease in Nigeria

Six Nigerians, consisting of 5 females and 1 male with confirmed inflammatory bowel disease (IBD) were recruited from a tertiary institution and two private hospitals in Lagos into this study from January 2001 to January 2014. Their ages at the time of first visit ranged from 27 to 65 years. They all had repeated bouts of bloody mucoid stools and abdominal pain plus or minus tenesmus requiring admission and fluid replacement. One of the cases even showed a total reversal of barium enema findings after the follow up treatment of oral sulphasalazine and prednisolone given. The four females and the male have remained relatively symptom free up to the time of their last visit in the follow up clinic, while one of the females was lost to follow up.
This is a prospective case series that highlights the need for a high index of suspicion to make a diagnosis of inflammatory bowel disease in an environment where the reported incidence is low. Its diagnosis requires a team approach between the gastroenterological surgeon, radiologist, gastroenterologist Physician and a sub-specialized pathologist.