title: Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences.
abstract: Although the incidence and prevalence of ulcerative colitis and Crohn's disease are beginning to stabilize in high-incidence areas such as northern Europe and North America, they continue to rise in low-incidence areas such as southern Europe, Asia, and much of the developing world. As many as 1.4 million persons in the United States and 2.2 million persons in Europe suffer from these diseases. Previously noted racial and ethnic differences seem to be narrowing. Differences in incidence across age, time, and geographic region suggest that environmental factors significantly modify the expression of Crohn's disease and ulcerative colitis. The strongest environmental factors identified are cigarette smoking and appendectomy. Whether other factors such as diet, oral contraceptives, perinatal/childhood infections, or atypical mycobacterial infections play a role in expression of inflammatory bowel disease remains unclear. Additional epidemiologic studies to define better the burden of illness, explore the mechanism of association with environmental factors, and identify new risk factors are needed.
authors.affiliation: Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA. loftus.edward@mayo.edu
authors.forename: Edward V
authors.initials: EV
authors.lastname: Loftus
mesh_terms: D001062:Appendectomy; D003276:Contraceptives, Oral / Q000009:adverse effects; D003710:Demography; D004032:Diet / Q000009:adverse effects; D004777:Environment; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D008457:Measles / Q000150:complications; D008458:Measles Vaccine / Q000009:adverse effects; D009164:Mycobacterium Infections / Q000150:complications; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D003276:Contraceptives, Oral; D008458:Measles Vaccine