Inflammatory bowel disease emerges as a global disease
The incidence and prevalence of inflammatory bowel disease (IBD) are increasing with time and in different regions around the world, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association.
"Insight into the worldwide epidemiology of inflammatory bowel disease is important for the identification of geographic patterns and time trends," said Gilaad G. Kaplan, MD, MPH, of the University of Calgary and lead author of this study. "Our findings will help researchers estimate the global public health burden of inflammatory bowel disease so that appropriate health-care resources are allocated, and targeted research is conducted in specific geographic regions," added Dr. Kaplan, an Alberta Innovates – Health Solutions population health investigator. View a video in which he discusses the study's findings and implications, and a patient recalls his experiences with Crohn's disease, a major illness recognized most often as IBD.
Population-based epidemiologic data of IBD collected in a standardized fashion in developing nations are sparse. To properly interpret the incidence or prevalence data and evaluate time trends, researchers conducted a systematic review of all population-based studies that describe the incidence and/or prevalence of IBD. They found that the incidence of IBD is increasing or stable in virtually every region of the world that has been studied.
Researchers found that the highest prevalence of IBD worldwide was reported in Canada and Europe, whereas Asia had a lower prevalence of IBD. In developing nations, IBD was a rare occurrence; however, as these nations have become more industrialized, the incidence of IBD has increased. Gender differences were inconsistent, suggesting that the disease occurred equally among females and males.
Universally, incidence rates for both Crohn's disease and ulcerative colitis were highest among individuals who were between 20 and 40 years old. Thus, IBD affects individuals in the most healthy and productive years of life, resulting in long-term cost to the patient, health-care system and society.
Despite more than 200 publications in the literature on IBD, this study highlights the need for incidence and prevalence data in many regions of the world, particularly from developing countries. Future studies in these regions are required to provide important insights into the etiology of IBD.
The two major illnesses that are recognized most often as inflammatory bowel disease are ulcerative colitis and Crohn's disease. The most common symptoms of ulcerative colitis, which occurs in the inner lining of the colon (large intestine) or rectum, are diarrhea, abdominal cramps and rectal bleeding. Patients suffering from Crohn's disease, an inflammation and ulceration process that occurs in the deep layers of the intestinal wall, experience pain in the abdomen — often in the lower right side — diarrhea, weight loss and occasionally bleeding.
