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Incidence and phenotypic characteristics of pediatric IBD in northeastern Slovenia, 2002-2010
Darja Urlep1, Tina K Trop, Rok Blagus
1*Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital Ljubljana, University Medical Center Ljubljana †Faculty of Medicine, Institute for Biostatistics and Medical Informatics, University of Ljubljana, Ljubljana, Slovenia.
Insights
The incidence of childhood inflammatory bowel disease (IBD) in northeastern Slovenia is high and increasing, comparable to Western Europe. Lifestyle changes, particularly in diet, may be contributing factors.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Inflammatory bowel disease (IBD) encompasses chronic inflammatory conditions of the gastrointestinal tract, primarily Crohn's disease (CD) and ulcerative colitis (UC).
- Understanding the epidemiological trends and phenotypic characteristics of pediatric IBD is crucial for healthcare planning and resource allocation.
Purpose of the Study:
- To determine the incidence of pediatric IBD and its subtypes (CD and UC) in northeastern Slovenia between 2002 and 2010.
- To analyze the phenotypic features of these conditions at diagnosis and during follow-up.
Main Methods:
- A retrospective cohort study of children (0-18 years) newly diagnosed with IBD in northeastern Slovenia from 2002-2010.
- Phenotypic characteristics, disease location (Paris classification), treatment, and surgical history were assessed.
- The study population represented approximately one-third of the pediatric population in the region.
Main Results:
- A total of 107 pediatric IBD cases were diagnosed.
- The mean annual incidence per 100,000 children was 7.6 for IBD, 4.6 for CD, and 2.8 for UC.
- Incidences showed an increasing trend from 2002-2004 to 2008-2010; complicated CD behavior doubled, and 18.5% of CD patients required surgery.
Conclusions:
- Childhood IBD incidence in northeastern Slovenia is high, mirroring developed Western European countries.
- The incidence appears to be still rising, potentially linked to lifestyle and dietary changes over the past two decades.
Objectives:
The purpose of the present study was to determine the incidence of inflammatory bowel disease (IBD) and its subgroups in children in northeastern Slovenia (NE Slovenia) during the period 2002-2010, and to assess the phenotypic characteristics at the diagnosis and during the follow-up.
Methods:
A retrospective investigation was conducted on a cohort of newly diagnosed children and adolescents with IBD ages 0 to 18 years between 2002 and 2010 and residing in NE Slovenia. The phenotypic characteristics were determined at presentation and during follow-up. The location of Crohn disease (CD) and ulcerative colitis (UC) was assessed according to the Paris classification at diagnosis, and later in patients who had a follow-up period >2 years. The type of therapy at diagnosis and during follow-up, and the need for surgery were determined. The study covered approximately one-third of the total pediatric population (0-18 years).
Results:
In total, 107 cases of IBD were diagnosed during the study period. The mean annual incidence (per 100,000) was 7.6 (95% confidence interval [CI] 6.3-9.2) for all IBD, 4.6 (95% CI 3.6-5.9) for CD, and 2.8 (95% CI 1.9-3.8) for UC. The incidences of total IBD, CD, and UC increased from 5.7 (3.8-8.2), 3.9 (2.3-6.1), and 1.8 (0.8-3.5) in the period 2002-2004, respectively, to 8.9 (6.3-12.2), 5.0 (3.1-7.6), and 3.4 (1.9-5.6) in the period 2008-2010, respectively. During the follow-up, the proportion of complicated CD disease behavior (stricturing/penetrating) had doubled. A total of 18.5% of patients with CD underwent bowel surgery.
Conclusions:
The incidence of childhood IBD in the northeastern part of the country is high and comparable with that reported from the developed western countries of Europe, and is probably still increasing. This increase may be the result of changes in the lifestyle, especially in dietary habits during the last 20 years.
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