Incidence and paris classification of pediatric inflammatory bowel disease.

Katalin Eszter Müller,Maria Papp,Gabor Veres,Peter Laszlo Lakatos

doi:10.1155/2014/904307

Abstract

New epidemiological data suggest that the incidence of inflammatory bowel disease (IBD) is increasing. As a result the burden of disease accounts for more strains to the health care system. The clinical variability queries whether disease characteristics are related to clinical outcome. Our aim was to delineate the latest results of incidence trends in pediatric IBD and to compare the first experiences with Paris Classification. Incidence of pediatric IBD has been increasing in Western Europe and in Eastern Europe. To better characterize IBD, Paris Classification was introduced and validated recently. Ileocolonic involvement is the most characteristic disease location in Crohn's disease (CD) based on applying Paris Classification. The rate of perianal disease and complicated behaviour in CD was similar. It is of interest that CD patients with colonic involvement were less likely to have stricturing disease compared with patients with ileal involvement. In addition, pancolitis dominated in ulcerative colitis (UC). However, most countries lack prospective, nationwide epidemiological studies to estimate incidence trends. This review emphasizes the importance of nationwide registries that enroll all pediatric IBD cases serving reliable data for “everyday practice.” These first reports have shown that Paris Classification is a useful tool to determine the pediatric IBD phenotype.

Highlights

The inflammatory bowel diseases (IBD), Crohn’s disease (CD), and ulcerative colitis (UC) are chronic inflammatory disorders of the gastrointestinal tract of unknown etiology
CD and UC account for substantial costs to the health care system and society [1]
In this report we summarize the latest incidence trends of pediatric IBD and the first experiences with Paris Classification

Summary

Introduction

The inflammatory bowel diseases (IBD), Crohn’s disease (CD), and ulcerative colitis (UC) are chronic inflammatory disorders of the gastrointestinal tract of unknown etiology. In most Western countries the incidence of adult UC and CD has stabilized, while incidence has been rising in regions with previously low incidence (Southern and Eastern Europe and Asia). In the latest systemic review about the changes in the worldwide incidence of IBD the highest incidence of adult UC was 24.3/105 person-years in Europe, 19.2/105 in North America, and 6.3/105 in Asia and the Middle East. It was concluded that the excess is less than expected on the basis of previous studies that may suggest an increase in the incidence of IBD in Southern Europe whereas those in the north may have reached a plateau. A few population-based cohort data have been reported from Eastern Europe showing an increase in previously less industrialized countries recently [23]. The heterogeneity of IBD frequency in different regions highlights the role of environmental factors

Incidence of Pediatric-Onset IBD

Methodological Problems in Assessing Incidence of IBD in Different Regions

Reasons for Rising Incidence

Incidence Rates in Childhood in Different Age Groups

Findings

Conclusions