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Inflammatory Bowel Disease Is Increasing

A review of published research worldwide showed increasing incidence of both Crohn disease and ulcerative colitis but lacked data from developing countries.

To summarize worldwide data on the incidence and prevalence of inflammatory bowel disease (IBD) — which comprises ulcerative colitis (UC) and Crohn disease (CD) — researchers systematically reviewed 238 incidence and 122 prevalence studies. The highest percentage of studies came from Europe, the second highest from Asia and the Middle East, and the third highest from North America.

Incidence rates of IBD were highest in Europe and North America, with lower rates in Asia and the Middle East. Incidence did not differ by sex but did differ by age, with the highest rates among 20- to 29-year-olds. Among studies with at least 10 years of data that tracked incidence over time, 75% showed increasing incidence of CD, and 60% showed increasing incidence of UC. Conversely, no studies of CD and only 6% of UC studies demonstrated decreasing incidence of these conditions. In studies conducted after 1980, 56% showed increasing incidence of CD and 29% showed increasing incidence of UC. Among studies demonstrating increasing incidence of IBD, the average annual percentage change ranged from 1.2% to 23.3% for CD and from 2.4% to 18.1% for UC.

Comment: These data are consistent with the theory that increasing rates of inflammatory bowel disease are associated with industrialization and urbanization and that IBD is becoming increasingly more common on a worldwide basis.

Douglas K. Rex, MD

Published in Journal Watch Gastroenterology February 3, 2012

Citation(s):

Molodecky NA et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012 Jan; 142:46.

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