Inflammatory bowel disease evolution in the past two decades: a chronological multinational study

Area of Science:

• Gastroenterology
• Epidemiology
• Internal Medicine

Background:

• Inflammatory bowel disease (IBD) is multifactorial with varied individual presentations.
• Understanding IBD's evolving behavior due to environmental factors is crucial for improved patient outcomes.

Purpose of the Study:

• To investigate changes in IBD behavior, presentation, and characteristics over the past two decades.
• To enhance the diagnosis, management, and outcomes for IBD patients.

Main Methods:

• A 6-month study (Feb-Jul 2022) collected data from IBD outpatient clinics across 6 countries.
• Patients were grouped by diagnosis timing: >15 years ago (Group A), 5-15 years ago (Group B), and <5 years ago (Group C).
• Prevalent IBD subtypes and characteristics were evaluated and compared between groups.

Main Results:

• 1430 IBD patients included: 84.5% ulcerative colitis (UC), 14.3% Crohn's disease (CD). Mean age at diagnosis was 30.
• Extra-intestinal involvement decreased in recent diagnoses (Group C) compared to older groups (A & B).
• UC subtypes shifted from extensive colitis to left-sided colitis in Group C. CD showed increased upper GI involvement. Food sensitivity and disease flares decreased in recent years.

Conclusions:

• Recent IBD presentation, particularly UC, has changed significantly.
• Increased upper GI involvement in CD and a higher prevalence of patients experiencing no disease flares are notable trends.
• Decreased extra-intestinal involvement suggests a potential shift in disease manifestation over time.