Geographic Distribution, Phenotype and Epidemiological Tendency in Inflammatory Bowel Disease Patients in Romania

Abstract

Background and objective: The incidence of inflammatory bowel disease (IBD) over the past years in Romania has been on the rise, but epidemiologic data are lacking. The aim of this study was to define the characteristics of IBD, the trends and phenotype among IBD patients in Romania. Material and methods: We conducted a prospective study over a period of 12 years, from 2006 to 2017. All patients diagnosed with IBD on clinical, radiological, endoscopic and histological features were included. We divided the country into eight regions: west (W), north-east (NE), north-west (NW), south-east (SE), south-west (SW), south (S), central (C) and Bucharest-Ilfov (B), and data were analyzed accordingly. Results: A total of 2724 patients were included in this database, but only 2248 were included in the final analysis, with all data available. Of the 2248 patients, 935 were Crohn’s disease (CD), 1263 were ulcerative colitis (UC) and 50 were IBD-undetermined. In UC phenotypes we observed more frequent left-sided colitis (50.5%, p < 0.0001), and in CD phenotype we observed more frequent colonic and ileo-colonic localization (37.8% and 37.6%, p < 0.0001). The region with the most IBD cases was NE (25.1%) and with the least IBD cases was SW (4.9%). UC was found more frequently in NE (32%), while CD was found more frequently in Bucharest (28.6%). Conclusions: In Romania, ulcerative colitis is more frequent than CD. UC is predominant in the northern part of Romania, while CD has become predominant in the southern part of the country. IBD occurs more in the male population, and in urban and industrialized areas. There are differences between the regions in Romania regarding IBD phenotypes, gender distributions, age distribution, treatment, smoking status and complications.

The Mediterranean Diet in Paediatric Gastrointestinal Disorders

“…Recent evidence indicates that a combination of susceptible genes, environment, altered microbial flora and inappropriate immune responses might be factors involved and functionally integrated in the pathogenesis of IBD [ 19 ]. As IBD incidence and prevalence both in the adult and in the paediatric population are constantly increasing [ 20 ], new data emerging from developing countries and migration studies suggest that environmental factors might play a major role [ 21 ]. Therefore the identification of IBD environmental risk factors and new therapies remain subjects of intensive research, and diet is one of the best candidates [ 3 , 19 ].…”

“…Nevertheless, none of these diets should be recommended to children and adolescents with IBD at present [ 26 ]. On the other hand, in recent years, much attention has been given to the role of MD in IBD [ 19 , 21 , 26 ].…”

Geographical heterogeneity in the disease characteristics and management of patients with inflammatory bowel disease, the preliminary results of a Chinese database for IBD (CHASE-IBD)

“…The distribution of IBD phenotypes and the clinical characteristics of patients with IBD across different geographic locations varied. 8,9 The industrialization and socioeconomic level of the Eastern China is significantly higher than those of the Western China. 10 There is a positive association of the incidence of IBD with gross domestic product (GDP) and east-to-west gradient for IBD with higher incidence in the east.…”