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The Changing Epidemiology of IBD

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Inflammatory Bowel Disease

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Incidence rates of IBD are increasing in areas of the world previously unaffected by these diseases. Among children, the incidence of Crohn’s disease (but not ulcerative colitis) has greatly increased. Age-specific incidence rates are highest for patients aged 20–40 years old. Specific population incidence rates first increase for ulcerative colitis, with an increase in Crohn’s disease seen 15–20 years later. Environmental factors associated with a decreased incidence of ulcerative colitis include smoking and appendicitis. Smoking is associated with a greater incidence of Crohn’s disease. A putative “North–South” in Northern America and Europe has been challenged by more recent studies.

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References

  1. Hawkins HP. Natural history of ulcerative colitis and its bearing on treatment. Br Med J. 1909;1:765–70.

    Article  PubMed  CAS  Google Scholar 

  2. Dalziel TK. Chronic interstitial enteritis. BMJ. 1913;2:1068–70.

    Google Scholar 

  3. Walker JF, Fielding JF. Crohn’s disease in Dublin in the latter half of the nineteenth century. Ir J Med Sci. 1988;157:235–7.

    Article  PubMed  CAS  Google Scholar 

  4. Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis. A pathological and clinical entity. J Am Med Assoc. 1932;99:1323–9.

    Article  Google Scholar 

  5. Stonnington CM, Philips SF, Melton III LJ, Zinsmeister AR. Chronic ulcerative colitis: incidence and prevalence in a community. Gut. 1987;28:402–9.

    Article  PubMed  CAS  Google Scholar 

  6. Sedlack RE, Nobrega FT, Kurland LT, Sauer WG. Inflammatory colon disease in Rochester, Minnesota, 1935–1964. Gastroenterology. 1972;62:935–41.

    PubMed  CAS  Google Scholar 

  7. Rose JD, Roberts GM, Williams G, Mayberry JF, Rhodes J. Cardiff Crohn’s disease jubilee: the incidence over 50 years. Gut. 1988;29:346–51.

    Article  PubMed  CAS  Google Scholar 

  8. Acheson ED. The distribution of ulcerative colitis and regional enteritis in United States veterans with particular reference to Jewish religion. Gut. 1960;1:291–3.

    Article  PubMed  CAS  Google Scholar 

  9. Samuelsson, S.M. (1976) Ulcerös colit och proctit. Thesis. Uppsala: Department of Social Medicine, University of Uppsala.

    Google Scholar 

  10. Norlén BJ, Krause U, Bergman L. An epidemiologic study of Crohn’s disease. Scand J Gastroenterol. 1970;5:385–90.

    PubMed  Google Scholar 

  11. Hellers G. Crohn’s disease in Stockholm County, 1955–1974. Acta Chir Scand. 1979;490(Suppl1):1–84.

    CAS  Google Scholar 

  12. Evand JG, Acheson ED. An epidemiological study of ulcerative colitis and regional enteritis in the Oxford area. Gut. 1965;6:311–24.

    Article  Google Scholar 

  13. Monk M, Mendeloff AI, Siegel CI, Lilienfeld A. An epidemiological study of ulcerative colitis and regional enteritis among adults in Baltimore. I Hospital incidence and prevalence, 1960 to 1963. Gastroenterology. 1968;54(Suppl):822–4.

    PubMed  Google Scholar 

  14. Sonnenberg A. Geographic variation in the incidence of and mortality from inflammatory bowel disease. Dis Colon Rectum. 1986;29:854–61.

    Article  PubMed  CAS  Google Scholar 

  15. Orholm M, Munkholm P, Langholz E, Haagen Nielsen O, Sörensen TIA, Binder V. Familial occurrence of inflammatory bowel disease. N Engl J Med. 1991;324:84–8.

    Article  PubMed  CAS  Google Scholar 

  16. Ekbom A, Helmick C, Zack M, Adami HO. The epidemiology of inflammatory bowel disease: a large, population-based study in Sweden. Gastroenterology. 1991;100:350–8.

    PubMed  CAS  Google Scholar 

  17. Bergman L, Krause U. The incidence of Crohn’s disease in central Sweden. Scand J Gastroenterol. 1975;10:725–9.

    PubMed  CAS  Google Scholar 

  18. Loftus Jr EV, Silverstein MD, Sandborn WJ, Tremaine WJ, Harmsen WS, Zinsmeister AR. Crohn’s disease in Olmsted County, Minnesota, 1940-1993: incidence, prevalence, and survival. Gastroenterology. 1998;114:1161–8.

    Article  PubMed  Google Scholar 

  19. Loftus Jr EV, Silverstein MD, Sandborn WJ, Tremaine WJ, Harmsen WS, Zinsmeister AR. Ulcerative colitis in Olmsted County, Minnesota, 1940–1993: incidence, prevalence, and survival. Gut. 2000;46:336–43.

    Article  PubMed  Google Scholar 

  20. Ekbom A, Helmick C, Zack M, Adami HO. Ulcerative proctitis in central Sweden 1965–1983. A population-based epidemiological study. Dig Dis Sci. 1991;36:97–102.

    Article  PubMed  CAS  Google Scholar 

  21. Lockhart-Mummery HE, Morson BC. Crohn’s disease (regional enteritis) of the large intestine and its distribution from ulcerative colitis. Gut. 1960;1:87–105.

    Article  PubMed  CAS  Google Scholar 

  22. Boller R. Erfahrungen and 89 Colitis-ulcerosa-Fällen der Abteilung Boller im allgemeinen Krankenhaus Wien. Gastroenterologia. 1956;86:693–6.

    Article  PubMed  CAS  Google Scholar 

  23. Samuelsson SM, Ekbom A, Zack M, Helmick CG, Adami HO. Risk factors for extensive ulcerative colitis and ulcerative proctitis: a population based case-control study. Gut. 1991;32:156–30.

    Article  Google Scholar 

  24. Persson PG, Ahlbom A, Hellers G. Crohn’s disease and ulcerative colitis. A review of dietary studies with emphasis on methodologic aspects. Scand J Gastroenterol. 1987;22:385–9.

    Article  PubMed  CAS  Google Scholar 

  25. Wright JP, Froggatt J, O’Keefe EA, et al. The epidemiology of inflammatory bowel disease in Cape Town 1980–1984. S Afr Med J. 1986;70:10–5.

    PubMed  CAS  Google Scholar 

  26. Sonnenberg A, McCarty DJ, Jacobsen SJ. Geographic variation in inflammatory bowel disease within the United States. Gastroenterology. 1991;100:143–9.

    PubMed  CAS  Google Scholar 

  27. Shivananda L, Lennard-Jones J, Logan R, et al. Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European collaborative study on inflammatory bowel disease (EC-IBD). Gut. 1996;39(5):690–7.

    Article  PubMed  CAS  Google Scholar 

  28. Brahme F, Lindstrom C, Wenckert A.. An epidemiological study of incidence, prevalence, mortality, and secular trends in the city of Malmö, Sweden. Gastroenterology. 1975;69:342–51.

    PubMed  CAS  Google Scholar 

  29. Binder V, Both H, Hansen PK, Hendriksen C, Kreiner S, Torp-Pedersen K. Incidence and prevalence of ulcerative colitis and Crohn’s disease in the County of Copenhagen 1962–1978. Gastroenterology. 1982;83:563–8.

    PubMed  CAS  Google Scholar 

  30. Manousos ON, Koutroubakis I, Potamianos S, Roussomoustakaki M, Gourtsoyiannis N, Vlachonikolis IG. A prospective epidemiologic study of Crohn’s disease in Heraklion, Crete. Incidence over a 5-year period. Scand J Gastroenterol. 1996;31:599–603.

    Article  PubMed  CAS  Google Scholar 

  31. Manousos ON, Giannadaki E, Mouzas IA, et al. Ulcerative colitis is as common in Crete as in northern Europe: a 5-year prospective study. Eur J Gastroenterol Hepatol. 1996;8:893–8.

    PubMed  CAS  Google Scholar 

  32. Sonnenberg A, Koch TR. Period and generation effects on mortality from idiopathic inflammatory bowel disease. Dig Dis Sci. 1989;34:1720–9.

    Article  PubMed  CAS  Google Scholar 

  33. Gent AE, Helliler MD, Grace RH, Swarbick ET, Coggon D. Inflammatory bowel disease and domestic hygiene in infancy. Lancet. 1994;343:766–7.

    Article  PubMed  CAS  Google Scholar 

  34. Montgomery SM, Pounder RE, Wakefield AJ. Infant mortality and the incidence of inflammatory bowel disease. Lancet. 1997;349:472–3.

    Article  PubMed  CAS  Google Scholar 

  35. Ekbom A, Adami HO, Helmick CG, Jonzon A, Zack M. Perinatal risk factors for inflammatory bowel disease: a case-control study. Am J Epidemiol. 1990;132:1111–19.

    PubMed  CAS  Google Scholar 

  36. Bartholomew C, Butler A. Inflammatory bowel disease in the West Indies. Br Med J. 1979;2:824–5.

    Article  PubMed  CAS  Google Scholar 

  37. Jayanthi V, Probert CSJ, Pinder D, Wicks ACB, Mayberry JF. Epidemiology of Crohn’s disease in Indian migrants and the indigenous population in Leicestershire. Q J Med. 1992;298:125–38.

    Google Scholar 

  38. Carr I, Mayberry JF. The effects of migration on ulcerative colitis: a three-year prospective study among Europeans and first- and second-generation South Asians in Leicester (1991–1994). Am J Gastroenterol. 1999;94:2918–22.

    PubMed  CAS  Google Scholar 

  39. Gearry RB, Richardson A, Frampton CM, Collett JA, Burt MJ, Chapman BA, et al. High incidence of Chron’s disease in Canterbury, New Zealand: results of an epidemiologic study. Inflamm Bowel Dis. 2006;12:936–43.

    Article  PubMed  Google Scholar 

  40. Odes HS, Fraser D, Krugliak P, Fenyves D, Fraser GM, Sperber AD. Inflammatory bowel disease in the Bedouin Arabs of southern Israel: rarity of diagnosis and clinical features. Gut. 1991;32:1024–6.

    Article  PubMed  CAS  Google Scholar 

  41. Blanchard JF, Bernstein CN, Wajda A, Rawsthorne P. Small-area variations and socioepidemographic correlates for the incidence of Crohn´s disease and ulcerative colitis. Am J Epidemiol. 2001;154:328–35.

    Article  PubMed  CAS  Google Scholar 

  42. Bernstein CN, Blanchard JF, Rawsthorne P, Wajda A. Epidemiology of Crohn’s disease and ulcerative colitis in a central Canadian province: a population.based study. Am J Epidemiol. 1999;149:916–24.

    Article  PubMed  CAS  Google Scholar 

  43. Moum B, Vatn MH, Ekbom A, et al. Incidence of ulcerative colitis and indeterminate colitis in four counties in southeastern Norway, 1990–1993. Scand J Gastroenterol. 1996;31:362–6.

    Article  PubMed  CAS  Google Scholar 

  44. Price AB. Overlap in the spectrum of non-spectrum inflammatory bowel disease – ‘colitis-indeterminate’. J Clin Pathol. 1978;31:567–77.

    Article  PubMed  CAS  Google Scholar 

  45. Moun B, Ekbom A, Vatn MH, et al. Inflammatory bowel disease: re-evaluation of the diagnosis in a prospective population based study in south eastern Norway. Gut. 1997;40:328–32.

    Google Scholar 

  46. Harries AD, Baird A, Rhodes J. Non-smoking: a feature of ulcerative colitis. Br Med J (Clin Res Ed). 1982;284:706.

    Google Scholar 

  47. Calkins BM. A meta-analysis of the role of smoking in inflammatory bowel disease. Br Med J (Clin Res Ed). 1989;34:1841–54.

    CAS  Google Scholar 

  48. Cottone M, Roselli M, Orlando A, Oliva L, Cappello M, Traina M, et al. Smoking habits and recurrence in Crohn’s disease. Gastroenterology. 1994;106:643–8.

    PubMed  CAS  Google Scholar 

  49. Tysk C, Järnerot G. Has smoking changed the epidemiology of ulcerative colitis? Scand J Gastroenterol. 1992;27:508–12.

    Google Scholar 

  50. Rhodes JM, Cockel R, Allan RN, Hawker PC, Dawson J, Elias E. Colonic Crohn’s disease and use of oral contraception. Br Med J. 1984;1:595–96.

    Article  Google Scholar 

  51. Boyko EJ, Theis MK, Vaughan TL, Nicol-Blades B. Increased risk of inflammatory bowel disease associated with oral contraceptive use. Am J Epidemiol. 1994;140:268–78.

    PubMed  CAS  Google Scholar 

  52. Morgan KL. Johne’s and Crohn’s. Chronic inflammatory bowel disease of infectious aetiology? Lancet. 1987;1(8540):1017–9.

    Article  PubMed  CAS  Google Scholar 

  53. Hermon-Taylor J. Causation of Crohn’s disease: the impact of clusters. Gastroenterology. 1993;104:643–6.

    PubMed  CAS  Google Scholar 

  54. Sartor RB. Does Mycobacterium avium subspecies paratuberculosis cause Crohn’s disease? Gut. 2005;54:896–8.

    Article  PubMed  Google Scholar 

  55. Gilat T, Hacohen D, Lilos P, Langman MJS. Childhood factors in ulcerative colitis and Crohn’s disease. Scand J Gastroenterol. 1987;22:1009–24.

    Article  PubMed  CAS  Google Scholar 

  56. Rutgeerts P, D’Haens G, Hiele M, Geboes K, Vantrappen G. Appendectomy protects against ulcerative colitis. Gastroenterology. 1994;106:1251–3.

    PubMed  CAS  Google Scholar 

  57. Andersson RE, Olaison G, Tysk C, Ekbom A. Appendectomy and protection against ulcerative colitis. N Engl J Med. 2001;344:808–14.

    Article  PubMed  CAS  Google Scholar 

  58. Barker DJP, Morris JA. Acute appendicitis, bathrooms, and diet in Britain and Ireland. Br Med J. 1988;296:953–8.

    Article  CAS  Google Scholar 

  59. Bernstein CN, Wajda A, Svenson LW, et al. The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol. 2006;101:1559–68.

    Article  PubMed  Google Scholar 

  60. Moum B, Vatn MH, Ekbom A, et al. Incidence of Crohn’s disease in four countries in southeastern Norwaym 1990–93. A prospective population-based study. Scand J Gastrorenterol. 1996;31:355–61.

    Article  CAS  Google Scholar 

  61. Lindberg E, Lindquist B, Holmquist L, Hildebrand H. Inflammatory bowel disease in children and adolescents in Sweden, 1984–1995. J Pediatr Gastroenterol Nutr. 2000;30:259–64.

    Article  PubMed  CAS  Google Scholar 

  62. Armitage E, Drummond H, Ghosh S, Ferguson A. Incidence of juvenile-onset Crohn’s disease in Scotland. Lancet. 1999;353:1496–7.

    Article  PubMed  CAS  Google Scholar 

  63. Askling J, Grahnquist L, Ekbom A, Finkel Y. Incidence of paediatric Crohn’s disease in Stockholm, Sweden. Lancet. 1999;354:1179.

    Article  PubMed  CAS  Google Scholar 

  64. Hildebrand H, Finkel Y, Grahnquist L, Lindholm J, Ekbom A, Askling J. Changing pattern of paediatric inflammatory bowel disease in northern Stockholm 1990–2001. Gut. 2003;52:1432–4.

    Article  PubMed  CAS  Google Scholar 

  65. Lakatos L, Mester G, Erdelyi Z, et al. Striking elevation in incidence and prevalence of inflammatory bowel disease in a province of Western Hungary beween 1977–2001. World J Gastroenterol. 2004;10:404–9.

    PubMed  Google Scholar 

  66. Sincić BM, Vucelić B, Persić M, Brncić N, Erzen DJ, Radaković B, et al. Incidence of ­inflammatory bowel disease in Primorsko-goranska County, Croatia, 2000–2004: A prospective population-based study. Scand J Gastroenterol. 2006;41(4):437–44.

    Article  PubMed  Google Scholar 

  67. Wiercinska-Drapalo A, Jaroszewicz J, Flisiak R, et al. Epidemiological characteristics of inflammatory bowel disease in north-eastern Poland. World J Gastroenterol. 2005;11:2630–3.

    Google Scholar 

  68. Gheorghe C, Pascu O, Gheoghe L, et al. Epidemiol inflammatory bowel disease adults who refer gastroenterology care Romania multicentre study. Eur J Gastroenterol Hepatol. 2004;16:1153–9.

    Article  PubMed  Google Scholar 

  69. Prikazka M, Letkovicova M, Natejikova V. Crohn’s disease in Slovakia: prevalence, socioeconomic and psychological analysis. Eur J Epidemiol. 1998;14:49–53.

    Article  PubMed  CAS  Google Scholar 

  70. Appleyard CB, Hernandez G, Rios-Bedoya CF. Basic epidemiology of inflammatory bowel disease in Puerto Rico. Inflamm Bowel Dis. 2004;10:106–11.

    Article  PubMed  Google Scholar 

  71. Edwards CN, Griffith SG, Hennis AJ, Hambleton IR. Inflammatory bowel disease: Incidence, prevalence, and disease characteristics in Barbados, West Indies. Inflamm Bowel Dis. 2008;14(10):1419–24.

    Google Scholar 

  72. Figueroa CC, Quera PR, Valenzuela EJ, et al. Inflammatory bowel disease: experience of two Chilea centers. Rev Med Chil. 2005;133:1295–304.

    Google Scholar 

  73. Souza MH, Troncon LE, Rodrigues CM, et al. Trends in the occurrence (1980–1999) and clinical features of Crohn’s disease and ulcerative colitis in a university hospital in southeastern Brazil. Arq Gastroenterol. 2002;39:98–105.

    Article  PubMed  Google Scholar 

  74. Abdul-Baki H, ElHajj I, El-Zahabi LM, et al. Clinical epidemiology of inflammatory bowel disease in Lebanon. Inflamm Bowel Dis. 2007;13:475–80.

    Article  PubMed  Google Scholar 

  75. Al-Ghamdi AS, Al-Mofleh IA, Al-Rashed RS, et al. Epidemiology and outcome of Crohn’s disease in a teaching hospital in Riyadh World. J Gastroenterol. 2004;10:1341–4.

    Google Scholar 

  76. Aghazadeh R, Zali MR, Bahari A, et al. Inflammatory bowel disease in Iran: a review of 457 cases. J Gastroenterol Hepatol. 2005;20:1691–5.

    Google Scholar 

  77. Sood A, Midha V, Sood N, et al. Incidence prevalence ulcerative colitis Punjab north India. Gut. 2003;52:1587–90.

    Article  PubMed  CAS  Google Scholar 

  78. Jian L, Xia B, Li J, Ye M, Yan W, Deng Y, et al. Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan city, central China. Inflamm Bowel Dis. 2006;12:212–17.

    Article  Google Scholar 

  79. Quyan Q, Tandon R, Goh KL, et al. The emergence of inflammatory bowel disease in the Asian Pacific region. Curr Opin Gastroenterol. 2005;21:408–13.

    Google Scholar 

  80. Yoon CM, Kim SB, Park IJ, et al. Clinical features of Crohn’s disease in Korea. Gastroenterol Jpn. 1988;23:576–81.

    PubMed  CAS  Google Scholar 

  81. Morita N, Toki S, Hirohashi T, et al. Incidence and prevalence of inflammatory bowel disease in Japan: nationwide epidemiological survey during the year 1991. Gastroenterology. 1995;30 Suppl 8:1–4.

    Google Scholar 

  82. Sakamoto N, Kono S, Wakai K, et al. Dieatary risk factors for inflammatory bowel disease: a multicenter case-control study in Japan. Inflamm Bowel Dis. 2005;11:154–63.

    Article  PubMed  Google Scholar 

  83. Gheorghe C, Pascu O, Cheorghe L, et al. Epidemiology of inflammatory bowel disease in adults who refer to gastroenterology care in Romania: a nulticentre study. Eur J Gastroenterol Hepatol. 2004;16:1153–9.

    Article  PubMed  Google Scholar 

  84. Firouzi F, Bahari A, Aghazadeh R, et al. Appendectomy, tonsillectomy, and risk of inflammatory bowel disease: a case control study in Iran. Int J Colorectal Dis. 2006;21:155–9.

    Article  PubMed  Google Scholar 

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  1. Department of Medicine, Clinical epidemiology unit M9:01, Karolinska Institute, 17176, Stockholm, Sweden

    Anders Ekbom

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  1. MC 4076, Sect. Of GE, Hepatol. & Nutr., Department of Medicine, University of Chicago Medical Center, S. Maryland Ave. 5841, Chicago, 60637, Illinois, USA

    Russell D. Cohen

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Ekbom, A. (2011). The Changing Epidemiology of IBD. In: Cohen, R. (eds) Inflammatory Bowel Disease. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-433-3_2

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