Epidemiology, course and socio-economic influence of inflammatory bowel disease

Based on the literature and on our own experience from a follow-up study of all inflammatory bowel disease patients in a defined population, the epidemiology, course and social economic aspects of the diseases are discussed. The incidence of ulcerative colitis has shown geographical differences with a stable incidence in Stockholm, Cardiff, the United Kingdom and Copenhagen compared to a remarkable increase in incidence in Iceland, Faroe islands, Norway, Scotland and North Tees since 1970. For Crohn's disease there has been an overall increase in incidence in all studies with a tendency towards a plateau in recent years in some areas. The prevalence of ulcerative colitis in 1978 was 117/10(5) and for Crohn's disease 34/10(5) in Copenhagen county. The survival of the patients did not differ from that of the background except for a small excess mortality in elderly men with ulcerative colitis within the first 2 years with the disease. 10% of patients with ulcerative colitis were colectomized within 1 year and 23% within 10 years. 55% of patients with Crohn's disease were operated on within 10 years, 11% two or more times. The number of patients in complete remission for 10 years after the initial attack is practically zero. 90% of patients with ulcerative colitis and about 80% with Crohn's disease have full work capacity. The risk of intestinal cancer is 1.4% in ulcerative colitis after 18 years (e.g. twice the risk in the background population) and is markedly lower than in previous reports. In Crohn's disease no increased risk of cancer was found.(ABSTRACT TRUNCATED AT 250 WORDS)