The Patient's Journey Through Inflammatory Bowel Disease: Diagnostic Delay and Its Clinical and Socioeconomic Impact

Background:
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), often begins with non-specific symptoms like abdominal pain, diarrhea, and rectal bleeding; complicating diagnosis. Delays in diagnosis can worsen the condition and affect quality of life. Factors such as symptom overlap with other diseases, varying severity, and lack of healthcare experience contribute to these delays. Additionally, limited access to specialized care, healthcare disparities, and insufficient awareness and education about IBD exacerbate the problem. The objective of this study is to analyze and describe the factors contributing to diagnostic delays in patients with IBD at the IBD Clinic of the General Hospital of Mexico “Dr. Eduardo Liceaga.”
Methods:
A cross-sectional study of 86 IBD patients used a structured survey to collect data on demographic factors, time from symptom onset to diagnosis, previous misdiagnoses, and treatment costs. Variables analyzed included sex, diagnosis type, age, years since diagnosis, number of hospitals visited, symptom duration before diagnosis, misdiagnoses, workdays lost, job loss, and economic costs. Descriptive statistical analysis was performed using SPSS version 29 for data processing and analysis.
Results:
From the 86 patients included in our study, 38.4% were men and 61.6% were women. Among them, 34.9% were diagnosed with CD and 65.1% with UC. The average age at diagnosis was 46.68 years (± 14.01 SD). The mean duration of symptoms before diagnosis was 7.25 years (± 7.87 SD), with 57% diagnosed within 1 year of symptom onset. Diagnostic delays significantly impacted most patients, with 73.3% receiving incorrect diagnoses before the correct IBD diagnosis. Common misdiagnoses included irritable bowel syndrome (19.8%), gastroenteritis (16.3%), and gastritis (14%). Socioeconomic impacts were significant, with over half of the patients (53.5%) losing their jobs due to the disease. Direct costs ranged from 10,125 to 65,750 Mexican pesos, and indirect costs ranged from 475 to 5,000 Mexican pesos.
Conclusions:
The delay in diagnosing IBD is significant, primarily due to insufficient medical experience, symptom overlap with other conditions, and socioeconomic barriers. This delay results in frequent misdiagnoses and has a severe impact on patients’ quality of life and financial situation. Urgent improvements are needed in access to specialized care and education about IBD for both healthcare professionals and the general public. These steps are crucial for reducing diagnostic delays and mitigating the adverse effects of the condition.