Both of our parents immigrated from Kerala, India to America for better lives and a better future for their family. They have been living here for 15 years now and within 10 years of their immigration they were both diagnosed with Crohn’s. Although this disease is detrimental, it has been introduced in to our lives. We decided this occurrence between both of our fathers was not just coincidence and we decided to investigate it. Crohn’s disease is an autoimmune disorder of the GI tract that inflames the walls and causes complications such as diarrhea and flare- ups. Crohn’s affect about 700,000 Americans and the medicine to help stop the immune system has devastating side effects. It is a inconvenience and troublesome for people who have this disease. We decided to look for anonymous patient data to see how genetic, environmental, and lifestyle factors effect Crohn’s disease.

Our project was studying the risk factors of Crohn’s disease, an autoimmune disorder of the bowels. An autoimmune disorder is when the immune system attacks the body’s own tissue. We hypothesized that age, gender, and race were risk factors that correlated with Crohn’s disease. We contacted Dr. Rudra Rai at Gastro Center Maryland to look for patient data on this matter. After looking at an anonymous patient database of 119 patients, we came to some conclusions. First of all, more women were likely to be susceptible to Crohn’s disease than men. 83 women had Crohn’s, while only 36 men had it. Secondly, Caucasians were most likely to get Crohn’s disease.

The sample of 119 contained 82 Caucasians, 23 African Americans, 9 Asian Indian, 1 Asian Israeli, 2 Hispanic, and 1 Filipino. Finally, those in there 50’s were more likely to have Crohn’s disease. A special correlation was also noticed in the Indian American population - that most of these people had gotten the disease within 10 years of moving to the United States. We find this correlation important because we saw that our parents follow this trend as well. We want to look in a lab and find the genetic triggers that cause Crohn’s. Specifically, we will look into Asian Indians and want to study change in diet, or environmental causes of Crohn’s.

Crohn’s disease is affected by risk factors such as age, sex, and race. We hypothesized that more males will be effected by Crohn’s. We also hypothesized there is a trend between Crohn’s and Indians who immigrated from India.

1. Formulate hypothesis and conduct background research 2. Contact Dr. Rudra Rai at Gastrocenter Maryland (or other source) with a patient database 3. Obtain a list of 119 random patients with Crohn’s disease 4. Search the patients in the database and note down their age, sex, and race 5. Ask Dr. Rai ( or other source) to provide any special information as needed 6. Repeat steps 2-6 if a sample size is biased or inaccurate

 Average and Median Age: 53  Regression model for age:.0047x  Range: 75 (96 is oldest, 21 is youngest)  Mode: 57 years old

 1 out of 544 people in the U.S have Crohn’s  Maryland: White-58%; Black – 29%; Hispanic – 8.15 %; Asian – 5.52%  Out of 318,000 Maryland Asians; 24% were Indian  Howard County : White-62%; Black-17%; Hispanic-6%; Asian-14%  Out of 41,000 Asians, 30% are Indians in Howard County  Maryland: Male %; Female %  Howard County: Male %; Female %  Indian Incidence Rate for Crohn’s:.4/10^5 persons per year  Indians tend to have a low incidence; illustrates environmental effects of moving to America  Population statistics are according to the 2010 census

 Crohn’s disease affects more females than males because the Howard County and Maryland gender ratios are approximately even and our data shows that there are many more females than males.  Race does not seem to be a factor because our data matches with the 2010 consensus of Maryland and it is not viable to say that one race is more effected than another.  Our data shows that average age of those effected is 53.  There seems to be a correlation with gender and immigration patterns.  We know that there is definitely a link between Crohn’s and immigrant from India because the incidence rate in India,.4/10^5, is extremely low compared to 1 out of every 544 people in America.  Immigration patterns with the Asian-Indian race hint that environmental factors and recent changes could spur Crohn’s disease. This agrees with our hypothesis and confirms that there is a trend.

 Looking to investigate this disease in clinical and laboratory settings and see if similar genes are associated with Crohn’s disease.

PatientImmigration #18Moved from India 15 years ago #29Contracted Crohn’s at age 30, born in the US #30Moved here years ago, Crohn’s started two years ago #73Came 10 years ago –diagnosed 1 year ago #76Came years ago, diagnosed 8 years ago #77Came 25 years ago, diagnosed 10 years ago #78Born here, diagnosed 10 years ago #111Born here, diagnosed 5 years ago #116Diagnosed recently, moved from India 15 years ago This proves that there is a trend when Indians emigrated from India to America.