Edinburgh, in Scotland, has one of the highest recorded rates of inflammatory bowel disease (IBD) in the world, higher than what is currently recognized, a study has found.
The study, “A Capture-Recapture Study of All-Age IBD Point Prevalence in Scotland,” was published in the journal Gut.
A recent review reported an IBD prevalence of 0.3% in Western countries. However, the prevalence of IBD in the U.K. has not been estimated since 2003.
In this study, eight IBD physicians manually screened the electronic records of patients in Lothian, Scotland, to identify true cases based on the Lennard-Jones/Porto criteria (considered the standard for diagnosis).
The researchers identified a total of 10,866 IBD cases, corresponding to a prevalence of 0.78%, or one in 125 people. Moreover, they state that this figure is expected to increase to greater than 1% (one in 98) by the end of 2028.
“This important study contributes to the growing evidence that the prevalence of IBD is significantly higher than is currently recognized,” Sarah Sleet, CEO of Crohn’s and Colitis UK, said in a press release.
IBD includes two conditions, Crohn’s disease (CD) and ulcerative colitis (UC), which are characterized by chronic inflammation of the gastrointestinal (GI) tract. These two conditions differ in the specific GI tract areas affected and their inflammation patterns, including the depth of GI wall involvement.
Although it is known that IBD results from an inappropriate response of the immune system to intestinal microflora antigens, the exact causes are still unclear. Environmental and genetic factors are believed to play a role.
Epidemiology, the study of how often diseases occur in different groups of people and why, provides some clues. IBD is more common in developed countries and in urban communities, suggesting that urbanization and a “westernized” lifestyle, including diet, play a role.
Hesse, Germany, has the highest known prevalence of CD in the world with 322 affected out of every 100,000 persons, whereas southeast Norway has the highest prevalence of UC, with 505 affected out of every 100,000 persons.
“IBD is a condition that disrupts the lives of patients and their families all too frequently,” said Gareth-Rhys Jones, clinical lecturer in IBD at the University of Edinburgh’s Centre for Inflammation Research. “Our findings highlight that more resources are needed to provide patients with the research, treatment and care they deserve.”
The new study revealed that in Edinburgh, CD affects 284 people out of every 100,000, and ulcerative colitis affects 432 people out of every 100,000, which is the second highest rate globally. Moreover, the researchers say these results can be extrapolated to the rest of the western world.
“There is no doubt that IBD is now becoming a global pandemic,” Charlie Lees, a consultant gastroenterologist in the Edinburgh IBD Unit, said. “This study provides much-needed data and can act as a launchpad for pivotal new studies to help patients.”