Increasing incidence of inflammatory bowel disease in children and adolescents: significance of environmental factors

Abstract

Inflammatory bowel disease (IBD) is a chronic relapsing im munemediated disease of the intestinal tract. Although its pre valence is reportedly lower in Asia than in Western countries, the rapid increase in the incidence of IBD has drawn attention to its etiology, including genetic susceptibility and environmental factors. Specifically, recent studies concerning dietary treatments and intestinal microbiota suggest that these factors may interact with the immune system, and the imbalance of this relationship may lead to immune dysregulation in IBD. Changes in diet or alterations in the composition of the intes tinal microbiota may be associated with the increasing incidence of IBD in Asia. Here, we aim to review recent studies on the role of diet and intestinal microbiota in IBD pathogenesis and the results of the investigations performed to modulate these factors.

Incidence and Prevalence Trends of Pediatric Inflammatory Bowel Disease in the Daegu-Kyungpook Province From 2017 to 2020

“…This change in eating habits and activity may have led to an increase of exposure to environmental risk factors. Changes in diet and consequent alteration in the composition of the intestinal microbiota may be associated with the increasing incidence of pediatric IBD ( 40 ).…”

Biomarkers for Optimization and Personalization of Anti-TNFs in Pediatric Inflammatory Bowel Disease

“…Almost 25% of cases are diagnosed before the age of 18 years [1], 20% before the age of 10 years [2], and 5% before the age of 6 years [3]. The incidence of the disease in children is increasing [4]. However, most clinical trials in this disease have been carried out in adults, and the results have been extrapolated with minimal changes to determine treatment in children.…”

Dietary role in the development and treatment of inflammatory bowel disease

“…described the dietary role as an environmental factor in developing inflammatory bowel disease. 5) Complex carbohy drates, fiberrich vegetables, and fruits have beneficial impli cations in gut homeostasis. 1,6) Shortchain fatty acids (SCFAs), mainly butyrate, which is produced from the bacterial fermen tation of nondigestible carbohydrates or amino acid degradation, demonstrate an antiinflammatory property through immuno modulation in both innate and adaptive immunity.…”

“…showed recent data on the efficacy of dietary modification and modulation of intestinal microbiota in the biologic era. 5) Exclusive enteral nutrition (EEN), the first introduced dietary intervention, achieves mucosal healing and has similar remission rates to those of corticosteroid in cases of newly diagnosed as well as relapsed pediatric active luminal CD. 6,9) EEN improves endoscopic severity and histology, supports continuous growth, and minimizes side effects.…”

“…In a review article, Park at al. described the dietary role as an environmental factor in developing inflammatory bowel disease [ 5 ]. Complex carbohydrates, fiber-rich vegetables, and fruits have beneficial implications in gut homeostasis [ 1 , 6 ].…”