Related Experiment Video
Updated: Oct 7, 2025
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Twenty-first Century Trends in the Global Epidemiology of Pediatric-Onset Inflammatory Bowel Disease: Systematic
M Ellen Kuenzig1, Stephen G Fung2, Luba Marderfeld2
1SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada; CHEO Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, CHEO, Ottawa, Ontario, Canada; CHEO Research Institute, Ottawa, Ontario, Canada.
Insights
Global rates of pediatric inflammatory bowel disease (IBD) are rising, with increases observed in incidence and prevalence. Data on very early onset IBD (VEO-IBD) remain limited, especially from developing nations.
Area of Science:
- Gastroenterology
- Epidemiology
- Pediatrics
Background:
- The global incidence of inflammatory bowel disease (IBD) is increasing, with a notable rise in pediatric cases.
- Previous epidemiological studies identified a lack of data concerning pediatric-onset IBD.
- This study addresses the need for comprehensive data on global trends in pediatric IBD.
Purpose of the Study:
- To systematically review global trends in the incidence and prevalence of IBD in individuals under 21 years old.
- To analyze geographic distribution and temporal changes in pediatric IBD over two decades.
- To assess available data on very early onset IBD (VEO-IBD).
Main Methods:
- Systematic review of studies indexed in MEDLINE, EMBASE, Airiti Library, and SciELO (January 2010–February 2020).
- Inclusion of population-based studies reporting incidence/prevalence of IBD, Crohn's disease, ulcerative colitis, or IBD-unclassified.
- Inclusion of data from studies published before 2000 via a prior systematic review; analysis of trends in all ages and VEO-IBD.
Main Results:
- 131 studies from 48 countries were included, with highest pediatric IBD rates in Northern Europe and North America.
- Most studies (84%) reported significant increases in pediatric IBD incidence, and all (100%) reported increased prevalence.
- Data on VEO-IBD incidence and prevalence are scarce and limited to high-incidence regions; trends were heterogeneous.
Conclusions:
- Pediatric-onset IBD rates continue to increase globally, with emerging data from new regions.
- Significant data gaps persist for VEO-IBD and pediatric IBD in developing countries.
- Further research is needed to understand the epidemiology of pediatric IBD in underrepresented regions.
Background & Aims:
The incidence of inflammatory bowel disease (IBD) is increasing internationally, particularly in nations with historically low rates. Previous reports of the epidemiology of pediatric-onset IBD identified a paucity of data. We systematically reviewed the global trends in incidence and prevalence of IBD diagnosed in individuals <21 years old over the first 2 decades of the 21st century.
Methods:
We systematically reviewed studies indexed in MEDLINE, EMBASE, Airiti Library, and SciELO from January 2010 to February 2020 to identify population-based studies reporting the incidence and/or prevalence of IBD, Crohn's disease, ulcerative colitis, and/or IBD-unclassified. Data from studies published before 2000 were derived from a previously published systematic review. We described the geographic distribution and trends in children of all ages and limiting to very early onset (VEO) IBD.
Results:
A total of 131 studies from 48 countries were included. The incidence and prevalence of pediatric-onset IBD is highest in Northern Europe and North America and lowest in Southern Europe, Asia, and the Middle East. Among studies evaluating trends over time, most (31 of 37, 84%) studies reported significant increases in incidence and all (7 of 7) reported significant increases in prevalence. Data on the incidence and prevalence of VEO-IBD are limited to countries with historically high rates of IBD. Time trends in the incidence of VEO-IBD were visually heterogeneous.
Conclusions:
Rates of pediatric-onset IBD continue to rise around the world and data are emerging from regions where it was not previously reported; however, there remains a paucity of data on VEO-IBD and on pediatric IBD from developing and recently developed countries.
Related Concept Videos
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD: