The epidemiology of inflammatory bowel disease: East meets west

Abstract

The incidence of inflammatory bowel diseases (IBD) in East has risen over the past decade to become a global disease. The increasing number of studies on the incidence and course of IBD in East has enabled us to explore East versus West differences in the epidemiology of IBD which could enhance our understanding of the heterogeneity of the disease and eventually assist in the discovery of novel therapeutic targets and design of preventive strategies. Comparison of population‐based data in East and West reveals that the incidence of IBD has risen rapidly in East while plateauing in West. Furthermore, the clinical presentation and course of IBD differs between East and West with more patients in East presenting with complicated disease. Considering the scarcity of population‐based data from East and the lack of studies with long durations of follow‐up, it remains to be clarified whether these differences reflect true differences in disease presentation. The effects of genetic and environmental risk factors contributing to IBD also differ between Eastern and Western populations. Considering the differential effects of genetic and environmental risk factors in East and West, future studies should seek to discover novel genetic and environmental risk factors which might specifically apply to eastern populations. In this narrative review, we compare the epidemiology of IBD between eastern and western countries by summarizing evidence from population‐based cohort studies in the last ten years. Furthermore, we look at differences in genetic susceptibility and environmental triggers of IBD between East and West.

The four epidemiological stages in the global evolution of inflammatory bowel disease

“…The True Rise in incidence is fundamentally an epidemiological transition state whereby individuals carrying genetic susceptibility mutations are exposed to environmental factors associated with the westernization of society that might alter their intestinal microbiota, particularly early in life, which could trigger IBD later in life 10 . Several reviews have contrasted the environmental determinants of IBD in the Western world with those of newly industrialized countries 10,54,55 . Overall, a pattern is observed such that the highest incidence of IBD has been reported in regions with the highest population density 10 .…”

Mucins in Intestinal Mucosal Defense and Inflammation: Learning From Clinical and Experimental Studies

“…UC is characterized by superficial inflammation radiating proximally from the rectum, whereas CD is characterized by zones of deeply inflamed and non-inflamed tissue that can extend throughout the GI tract (136). These conditions affect millions worldwide, and the incidence is increasing globally (137).…”

Ulcerative colitis: understanding its cellular pathology could provide insights into novel therapies

“…It is usually possible to notice a clear margin between normal and affected intestinal tissue [7]. There has been a global increase in UC incidence, with the highest incidence in the West observed in Canada (16.7 per 100,000 people) [8], while in Europe UC incidence ranges from 1.6 to 11.9 per 100,000 people, with more patients observed in Northern European countries [9]. In the East, although UC incidence is increasing, it is rarer with the greatest incidence observed in Korea (3.62 per 100,000) [10].…”