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Rapid rise in incidence of Irish paediatric inflammatory bowel disease
B Hope1, R Shahdadpuri, C Dunne
1National Centre for Paediatric Gastroenterology, Hepatology and Nutrition, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.
Insights
Childhood inflammatory bowel disease (IBD) incidence significantly increased in Ireland between 2000-2010. However, disease presentation and 2-year outcomes for Crohn
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Inflammatory Bowel Disease Research
Background:
- Inflammatory Bowel Disease (IBD) is a chronic condition affecting children.
- Understanding trends in pediatric IBD incidence and phenotype is crucial for public health.
- Previous studies have indicated potential increases in IBD globally.
Purpose of the Study:
- To analyze changes in pediatric IBD incidence in Ireland from 2000 to 2010.
- To investigate if the disease phenotype and outcomes have altered over this decade.
- To compare patient groups diagnosed in 2000-2001 versus 2008.
Main Methods:
- Calculated annual IBD incidence in Irish children (<16 years) from 2000-2010.
- Phenotyped patient cohorts using the Paris Classification for diagnosis in 2000-2001 (Group A) and 2008 (Group B).
- Compared disease phenotype at diagnosis and 2-year follow-up between groups.
Main Results:
- Identified 406 new pediatric IBD cases.
- Incidence rose significantly, with rates of 2.5/100,000/year in 2001 to 7.3 in 2008.
- No differences observed in disease location at diagnosis or Crohn's disease behavior between patient groups.
Conclusions:
- A substantial and sustained increase in childhood ulcerative colitis (UC) and Crohn's disease (CD) incidence occurred in Ireland.
- Disease phenotype at diagnosis remained consistent.
- CD progression at 2 years appeared less frequent than in some other countries, with reasons yet unexplained.
Aims:
To describe the change in incidence of paediatric inflammatory bowel disease (IBD) observed at the National Centre for Paediatric Gastroenterology, Hepatology and Nutrition, and to determine whether the presenting disease phenotype and disease outcomes have changed during the past decade.
Methods:
The annual incidence of IBD in Irish children aged <16 years was calculated for the years 2000-2010. Two subsets of patients, group A (diagnosed between 1 January 2000 and 31 December 2001), and group B (diagnosed between 1 January and 31 December 2008) were phenotyped according to the Paris Classification. Phenotype at diagnosis and 2-year follow-up were then compared.
Results:
406 new cases of IBD were identified. The incidence was 2.5/100 000/year in 2001, 7.3 in 2008 and 5.6 in 2010, representing a significant increase in the number of new cases of Crohn's disease (CD) and ulcerative colitis (UC). There were 238 cases of CD; 129 of UC; and 39 of IBD unclassified. Comparing groups A and B, no differences were found in disease location at diagnosis or, for CD, in its behaviour.
Conclusions:
There has been a substantial and sustained increase in the incidence of childhood UC and CD in Ireland over a relatively short period of time. However, disease phenotype at diagnosis has not changed. At 2 years follow-up, CD appears to progress less frequently than in some neighbouring countries. These variations remain unexplained. Prospective longitudinal studies will help to elucidate further the epidemiology of childhood IBD.
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