Researchers in southern Spain studied over 2,700 people with inflammatory bowel disease (IBD) to understand how the condition affects native Spanish residents compared to immigrants. They found that native Spaniards developed the disease more often and experienced more severe symptoms than immigrants from Africa, Latin America, and Central Europe. Interestingly, immigrants were diagnosed at younger ages but had milder disease overall. The study suggests that factors like diet, healthcare access, and lifestyle differences between groups may explain why some populations experience worse IBD symptoms than others.

The Quick Take

  • What they studied: How often inflammatory bowel disease occurs and how severe it is in native Spanish people versus immigrants living in Granada, Spain
  • Who participated: 2,764 people with inflammatory bowel disease treated between 2012-2022. A detailed comparison group included 144 patients (111 native Spanish, 33 immigrants from Africa, Latin America, and Central Europe), matched by age, sex, and disease type
  • Key finding: Native Spaniards were diagnosed with IBD about 5 times more often than immigrants (6.49 vs 1.32 cases per 100,000 people per year), and experienced severe disease more frequently (37.8% vs 21.2%). However, immigrants were diagnosed at younger ages on average
  • What it means for you: If you’re an immigrant in southern Spain with IBD, you may experience milder disease than native residents. If you’re native Spanish with IBD, you should be aware you may be at higher risk for more severe symptoms and should work closely with your doctor on management. These patterns suggest lifestyle and environmental factors play important roles in disease severity.

The Research Details

This was a retrospective study, meaning researchers looked back at medical records from 2012 to 2022 to track what happened to IBD patients in Granada. They collected information from multiple hospitals and clinics to get a complete picture of the disease in the region. The researchers carefully matched immigrants and native Spaniards by age, sex, and type of IBD to make fair comparisons. They used statistical methods to identify which factors (like nationality, number of hospital visits, or disease type) were most strongly connected to severe disease.

By studying real patients over a 10-year period in an actual community, researchers can understand how disease patterns differ between groups in everyday life, not just in controlled experiments. This approach helps identify environmental and lifestyle factors that might protect or harm people with IBD.

This study is fairly reliable because it included a large number of patients (2,764 total) and tracked them over a full decade. The researchers used multiple hospitals to avoid bias from a single location. However, the detailed comparison group was smaller (144 patients), which means some findings should be interpreted cautiously. The study was conducted in one region of Spain, so results may not apply everywhere.

What the Results Show

Native Spaniards had significantly higher rates of IBD diagnosis compared to immigrants. For every 100,000 native Spanish people, about 6.49 new cases of IBD were diagnosed each year, compared to only 1.32 cases per 100,000 immigrants. When looking at total cases in the population (prevalence), native Spaniards had 295 cases per 100,000 people, while immigrants had only 41 cases per 100,000. Severe disease—meaning more symptoms, more hospital visits, and more procedures needed—affected 37.8% of native Spaniards but only 21.2% of immigrants. Interestingly, immigrants were diagnosed at a younger average age (38.8 years) compared to native Spaniards (47.7 years), suggesting the disease may develop differently in these groups.

The study identified specific factors that predicted severe disease. Patients with Crohn’s disease (one type of IBD) were more likely to have severe symptoms than those with ulcerative colitis. Patients who needed three or more colonoscopies (camera procedures to examine the intestines) were 7 times more likely to have severe disease. Those hospitalized three or more times were 7.75 times more likely to have severe disease. Being Spanish nationality was independently associated with more severe disease, even after accounting for other factors. Most immigrant patients came from Africa (57.5%), followed by Latin America (27.3%) and Central Europe (15.2%).

This research fits with existing knowledge that IBD is more common in developed, northern European countries than in southern Europe or developing nations. The rates found in Granada are lower than those reported in northern Europe, which aligns with previous research. The finding that immigrants have milder disease is relatively new and suggests that factors beyond genetics—such as diet, environmental exposures, or healthcare systems—play important roles in IBD severity. The Mediterranean diet and Spain’s universal healthcare system may protect against severe disease.

The study looked back at medical records rather than following people forward in time, which can miss some information. The detailed comparison group of 144 patients is much smaller than the total 2,764, so some specific findings may not be as reliable. The study only included people in Granada, so results may not apply to other regions of Spain or other countries. The researchers couldn’t account for all possible lifestyle differences between groups, such as specific dietary habits or stress levels. Some immigrants may have had IBD before moving to Spain, which could affect the results.

The Bottom Line

If you’re a native Spanish resident with IBD, work with your gastroenterologist to develop a comprehensive management plan, as you may be at higher risk for severe disease. If you’re an immigrant with IBD, continue regular medical monitoring even though your disease may be milder on average—individual cases vary. For all IBD patients, maintaining a healthy diet (Mediterranean-style diets show promise), ensuring regular healthcare access, and staying engaged with medical care appear important for managing disease severity. These recommendations are based on observational evidence, so discuss personalized approaches with your doctor.

This research is most relevant to people living in southern Spain with IBD or at risk for IBD, healthcare providers treating IBD patients in Mediterranean regions, and public health officials planning healthcare resources. It’s also important for researchers studying how migration and lifestyle affect digestive diseases. People with IBD in other regions should note that while patterns may differ, the general principles about diet and healthcare access likely apply broadly.

Changes in IBD severity typically develop over months to years. If you make lifestyle modifications or improve healthcare engagement, you may notice improvements in symptoms within weeks to months, but significant changes in disease severity usually take 6-12 months or longer to become apparent. Regular monitoring with your doctor is essential to track progress.

Want to Apply This Research?

  • Track the number of colonoscopies and hospitalizations you have each year, along with symptom severity ratings (1-10 scale). This helps identify patterns and predict disease progression, as the study found these factors strongly predict severe disease.
  • Use the app to log daily dietary choices, focusing on Mediterranean diet components (olive oil, vegetables, fish, whole grains). Also track stress levels and sleep quality, as these may influence IBD severity. Set reminders for regular doctor appointments and medication adherence.
  • Create a quarterly review in the app comparing your hospitalization frequency, procedure needs, and symptom patterns. Share this data with your healthcare provider to catch worsening disease early. Monitor whether lifestyle changes correlate with symptom improvements over 3-6 month periods.

This research describes patterns in a specific population in southern Spain and should not be used for self-diagnosis or self-treatment. If you have symptoms of inflammatory bowel disease (chronic diarrhea, abdominal pain, blood in stool), consult a healthcare provider for proper evaluation. The findings suggest associations between nationality and disease severity but do not prove causation. Individual cases vary significantly, and your personal risk depends on many factors not covered in this study. Always work with your gastroenterologist or healthcare provider to develop a treatment plan tailored to your specific situation. This information is for educational purposes and does not replace professional medical advice.