The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study

Abstract

The incidence of inflammatory bowel disease in a rural region of Southern Germany: a prospective population-based study Abstract OBJECTIVE: Although important advances in understanding the aetiology and pathogenesis of inflammatory bowel disease (IBD) have been made, many questions remain unanswered. As the most recent data available on the incidence of IBD in Germany were collected about 15 years ago, we set up a new population-based cohort to determine current incidence data for a defined region in Germany and to establish a basic cohort for prospective follow-up. METHODS: All patients living in the region of Oberpfalz newly diagnosed with IBD between 1 January 2004 and 31 December 2006 were included in this study by setting up a network of reporting clinicians and general practitioners in hospitals as well as in private practices. Demographic and clinical characteristics such as age at first diagnosis, localization of the disease, extraintestinal manifestations or family history on IBD were documented. Age-adjusted incidence rates are presented with 95% Poisson confidence intervals (CIs), based on the European standard population. RESULTS: In total, 286 newly diagnosed patients with IBD were reported in this region, 168 patients suffering from Crohn's disease (CD), 105 patients with ulcerative colitis. Age-standardized incidence rates were 11.0/10(5) (95% CI: 9.1-11.6) for IBD, 6.6/10(5) (95% CI: 5.6-7.7) for CD and 3.9/10(5) (95% CI: 3.2-4.7) for ulcerative colitis. Peak incidences were found in the age interval of 16-24 years for both diseases, predominantly for CD. Age at first diagnosis was lower, extraintestinal manifestations and a positive family history on IBD were more common in patients with CD. CONCLUSION: The incidence rate in IBD seems to be stable in Germany as compared with previously reported data, as is the remarkable predominance of CD. Prospective follow-up studies will be based on this incidence cohort.Incidence of IBD in the region of Oberpfalz ResultsIn total, 286 newly diagnosed patients with IBD were reported from this region, 168 patients suffering from Crohn´s disease (CD), 105 patients with ulcerative colitis (UC). Agestandardized incidence rates were 11.0/10 5 (95% CI 9.1-11.6) for IBD, 6.6/10 5 (95% CI 5.6-7.7) for CD and 3.9/10 5 (95% CI 3.2-4.7 ) for UC respectively. Peak-incidences were found in the age interval 16-24 years for both diseases with a lower extent in UC. Age at first diagnosis was lower, and extraintestinal manifestations and family history on IBD were more common in patients with CD. ConclusionThe incidence rate in IBD seems to be stable in Germany as compared to previously reported data, as is the remarkable predominance of CD.

Geographical variability and environmental risk factors in inflammatory bowel disease

“…Compared to the rest of Europe,13 52 53 a higher incidence rate for UC than for CD has been reported in Nordic countries 14 21 54. The reason for this is not completely clear.…”

Natural history and complications of IBD

“…UC seems more common than CD in industrialized countries of northern areas of western Europe [6], unlike Canada [9]; however, this UC/CD difference is less prominent in southern Europe. In northern France, the opposite seems to be the case [6], with a higher incidence rate for CD than for UC; because this prevalence also seems to be the case for southern Germany [10], we may no longer describe this as a French enigma, but perhaps as a tendency for middle Europe. Regarding gender, females are overrepresented in CD and males in UC.…”

A Rare Case of a Complex System of Fistulas in Crohns Disease

“…Crohn's disease has an incidence of 6.6 per 100,000 in southern Germany and is the most common form of inflammatory bowel disease beside ulcerative colitis [1]. The prevalence can be set at 100-200 per 100,000 [2].…”