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Forbes AJ, Frampton CMA, Day AS, Kaplan GG, Gearry RB. The Epidemiology of Inflammatory Bowel Disease in Oceania: A Systematic Review and Meta-Analysis of Incidence and Prevalence. Inflamm Bowel Dis 2023:izad295. [PMID: 38159083 DOI: 10.1093/ibd/izad295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Past studies have shown high rates of inflammatory bowel disease (IBD) in Australia and New Zealand (NZ). We aimed to describe the epidemiology of IBD in Australia, NZ, and the surrounding region (collectively termed Oceania) by conducting a systematic review and meta-analysis. METHODS Electronic databases were searched from inception to April 2023 for studies reporting incidence or prevalence rates of IBD, Crohn's disease (CD), or ulcerative colitis (UC) in Oceania. All study designs were included. A meta-analysis calculated pooled estimates of incidence and prevalence, and a sensitivity analysis compared the pooled population-based studies with the non-population-based studies and the Australian and NZ studies separately. RESULTS Nineteen incidence and 11 prevalence studies were included; 2 studies were from the Pacific Islands, with the rest coming from Australia and NZ. Pooled estimates showed high incidence rates of 19.8 (95% confidence interval [CI], 15.8-23.7) for IBD, 8.3 (95% CI, 6.9-9.8) for CD, and 7.4 (95% CI, 5.7-9.1) for CD per 100 000 person-years. CD was more common than UC in most studies. The pooled estimates for the prevalence studies were 303.3 (95% CI, 128.1-478.4) for IBD, 149.8 (95% CI, 71.0-228.5) for CD, and 142.2 (95% CI, 63.1-221.4) for UC per 100 000 persons. Studies using population-based data collection methods showed higher pooled rates for both incidence and prevalence. CONCLUSIONS The incidence and prevalence of IBD in Oceania is high. The studies were heterogeneous and there were several geographic areas with no information, highlighting the need for more epidemiological studies of IBD.
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Affiliation(s)
- Angela J Forbes
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Chris M A Frampton
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Gilaad G Kaplan
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Richard B Gearry
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
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Xu L, He B, Sun Y, Li J, Shen P, Hu L, Liu G, Wang J, Duan L, Zhan S, Wang S. Incidence of Inflammatory Bowel Disease in Urban China: A Nationwide Population-based Study. Clin Gastroenterol Hepatol 2023; 21:3379-3386.e29. [PMID: 37660767 DOI: 10.1016/j.cgh.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 07/25/2023] [Accepted: 08/07/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND & AIMS Limited studies have evaluated the burden of inflammatory bowel disease (IBD) in China. We aimed to estimate the incidence of IBD including ulcerative colitis (UC) and Crohn's disease (CD) in urban China. METHODS The national urban incidence in 2016 was calculated based on urban basic medical insurance from 2012 to 2016 in China by using a 4-year washout period. The incidence in Yinzhou District estimated from the Yinzhou electronic health care record database was used to test the accuracy of the results from insurance data. RESULTS A total of 95,555 patients with IBD were identified. The incidence in 2016 was 10.04 (95% confidence interval, 6.95-13.71) per 100,000 person-years. The incidence rates of both UC and CD were higher among males than among females. There was a sharp increase in UC incidence before the age of 30 years and stabilization in later years (50-79 years old), whereas CD incidence peaked at 30 to 34 years old and experienced decline subsequently. The incidence of UC was much greater than that of CD, with a UC-to-CD incidence ratio of 12.61. The results from the Yinzhou database confirmed these results. CONCLUSIONS This study is the first to draw a portrait of the distribution of IBD in urban China. The difference in IBD incidence between urban China and other countries suggests an association between the IBD burden and industrialization process. The accelerating urbanization and industrialization process in China, a country with a population of 1.4 billion people, will likely increase the burden of IBD.
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Affiliation(s)
- Lu Xu
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Haidian District, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Haidian District, Beijing, China
| | - Bingjie He
- Healthcare Security Administration of Guangdong Province, Yuexiu District, Guangzhou, Guangdong, China
| | - Yexiang Sun
- Department of Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Jun Li
- Department of Gastroenterology, Peking University Third Hospital, Haidian District, Beijing, China
| | - Peng Shen
- Department of Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Liming Hu
- Department of Data Center, Yinzhou District Center for Disease Control and Prevention, Ningbo, Zhejiang, China
| | - Guozhen Liu
- Peking University Health Information Technology Co., Ltd., Haidian District, Beijing, China
| | - Jinxi Wang
- Shanghai Songsheng Business Consulting Co., Ltd., Dongcheng District, Beijing, China
| | - Liping Duan
- Department of Gastroenterology, Peking University Third Hospital, Haidian District, Beijing, China.
| | - Siyan Zhan
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Haidian District, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Haidian District, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Haidian District, Beijing, China; Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Haidian District, Beijing, China.
| | - Shengfeng Wang
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Haidian District, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Haidian District, Beijing, China.
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Seleq S, Weilert F, Fulforth J. Inflammatory bowel disease in Waikato, New Zealand: incidence and prevalence. Intern Med J 2023; 53:2307-2312. [PMID: 36916153 DOI: 10.1111/imj.16072] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/07/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease (IBD) prevalence is rising globally; however, indigenous groups are underrepresented. Waikato, New Zealand, is a large region with a high proportion of Māori patients. In Canterbury in 2006, 1% of patients with IBD were Māori. We investigated the incidence and prevalence of IBD in Waikato over 10 years. METHODS This was a retrospective cohort study assessing the incidence and prevalence of IBD between 2009 and 2019. The search strategy included pathology, radiology, Provation, ICD-10 coding and private clinics, using the keywords: Crohn's, Crohn, ileitis, colitis, ulcerative, inflammatory bowel disease and IBD. Collected data included current age and age at diagnosis, sex, ethnicity and IBD subtype. RESULTS The IBD point prevalence on 31 December 2019 was 375.6/100 000 compared with 293.6/100 000 in 2010, increasing by 27.9%. The annualised incidence was static from 21.5/100 000 in 2010 to 17.5/100 000 in 2019. Female patients comprised 53.3% of the cohort. Ulcerative colitis (UC) made up 54.2% of cases, 43.8% had Crohn disease (CD) and 2.0% had indeterminate colitis. Sixty (3.7%) patients identified as Māori. In non-Māori patients, the average age at diagnosis was 36.2 years, compared with 33.0 years in Māori patients (P = 0.11). In Māori patients, 53.3% had UC and 45.0% had CD. Thirty-five percent of Māori patients lived 50 km or more from base hospital, compared with 41% of non-Māori patients (P = 0.33). CONCLUSION IBD prevalence has increased substantially; however, the incidence has remained static. Māori IBD rates are higher than previously reported, in keeping with international indigenous trends. Māori patients were diagnosed at a similar age as non-Māori patients, with similar disease subtypes.
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Affiliation(s)
- Samir Seleq
- Waikato District Health Board, Hamilton, Waikato, New Zealand
| | - Frank Weilert
- Waikato District Health Board, Hamilton, Waikato, New Zealand
| | - James Fulforth
- Waikato District Health Board, Hamilton, Waikato, New Zealand
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Olivera PA, Parks ML, Pellegrini D, Finn B, Gutierrez R, Zubiaurre I, Lasa J. Incidence and prevalence of inflammatory bowel diseases in a population from Buenos Aires, Argentina. GASTROENTEROLOGIA Y HEPATOLOGIA 2023:S0210-5705(23)00440-5. [PMID: 37806345 DOI: 10.1016/j.gastrohep.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/07/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Inflammatory bowel diseases (IBD) incidence and prevalence in Latin America have experienced a significant shift in the last decades. There is paucity of IBD epidemiologic data in Argentina. AIM To determine the incidence and prevalence of IBD between 2018 and 2022 of a population from the city of Buenos Aires. MATERIALS AND METHODS From January 1st, 2018 to December 31st, 2022, the total population of two healthcare insurances were studied. 'Possible' IBD cases were identified using the following information sources: IBD-unit patient databases; electronic medical record; central laboratory electronic database; histopathology electronic database; pharmacy electronic database. Age-adjusted incidence and prevalence rates for Crohn's disease (CD), ulcerative colitis (UC) and IBD were estimated based on the number of patients compared with the at-risk population and expressed per 100,000 subjects. Trends in IBD incidence and prevalence were estimated as annual percentage changes; we used Poisson regression modeling to calculate significance in these trends over time. RESULTS Information source analysis rendered 172 possible cases, of which 82 cases of IBD were finally confirmed: 27.16% were CD and 72.84% were UC. Mean age-standardized incidence across the study period for IBD, CD and UC was 11.93 (11.28-12.55), 2.88 (2.65-3.07) and 9.05 (8.83-9.2) respectively. Point prevalence on December 31st, 2022 for IBD, UC and CD was 134 (95%CI 132.3-135.6), 98 (96.95-99.52) and 36 (35.69-36.4) respectively. CONCLUSIONS We found an incidence and prevalence of IBD in a population from Buenos Aires higher than those previously published in epidemiological studies in Argentina.
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Affiliation(s)
- Pablo Andrés Olivera
- Inflammatory Bowel Disease Unit, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina; Zane Cohen Centre for Digestive Diseases, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - María Laura Parks
- Gastroenterology Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Deborah Pellegrini
- Health Informatics Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina; Internal Medicine Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Bárbara Finn
- Internal Medicine Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Ramiro Gutierrez
- Internal Medicine Department, Centro de Educación Médica en Investigación Clínica (CEMIC), Buenos Aires, Argentina
| | - Ignacio Zubiaurre
- Gastroenterology Department, Hospital Británico de Buenos Aires, Buenos Aires, Argentina
| | - Juan Lasa
- Inflammatory Bowel Disease Unit, Centro de Educación Médica e Investigación Clínica (CEMIC), Buenos Aires, Argentina.
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Flanagan A, Allsopp SM, O'Connor SA, Tobin J, Pretorius C, Brown IS, Bell S, Daveson AJM. High incidence of inflammatory bowel disease in Northern Australia: a prospective community population-based Australian incidence study in the Mackay-Isaac-Whitsunday region. Intern Med J 2023; 53:1602-1609. [PMID: 36579712 DOI: 10.1111/imj.15941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 09/27/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS To determine the incidence of inflammatory bowel disease (IBD) in the Mackay-Isaac-Whitsunday region in Northern Queensland (-21.14° S) and to allow a comparison with Southern Australian and New Zealand data (Geelong, Australia -38.14° S; Tasmania -41.43° S and -42.88° S (Launceston and Hobart) and Canterbury, New Zealand -43.46 °S). DESIGN A prospective observational community population-based IBD study was conducted between 1 June 2017 and 31 May 2018. OUTCOME MEASURES Primary includes the crude annual incidence rate of IBD, Crohn's disease (CD), ulcerative colitis (UC) and inflammatory bowel disease-unclassified (IBDU), while secondary includes disease phenotype and behaviour. RESULTS Fifty-six new cases of IBD were identified. Twenty-three were CD, 30 were UC and 3 were IBDU. The crude annual incidence rate per 100 000 for IBD, CD, UC and IBDU were 32.2 (95% confidence interval (CI): 24.78-41.84), 13.23 (95% CI: 8.79-19.90), 17.25 (95% CI: 12.06-24.67) and 1.73 (95% CI: 0.56-5.35). When directly age-standardised to the World Health Organisation Standard Population Distribution, the overall CD, UC and IBDU incidence were 13.19, 17.34 and 1.85 per 100 000, with an overall age-standardised IBD incidence of 32.38. CONCLUSIONS This is the first study to define the incidence of IBD in a Northern Australian cohort and to allow a comparison between North and Southern Australia. The IBD crude is the highest reported in Australia. Like others, we found a high and low incidence of upper gastrointestinal Crohn's disease and complicated disease at diagnosis respectively, likely reflective of the increased availability and early uptake of endoscopic procedures.
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Affiliation(s)
| | - Susan M Allsopp
- EndosQ Gastroenterologists, Mackay, Queensland, Australia
- Mater Misericordiae Hospital, Hospital Mackay, Mackay, Queensland, Australia
- Mackay Base Hospital, Mackay, Queensland, Australia
| | - Sam A O'Connor
- EndosQ Gastroenterologists, Mackay, Queensland, Australia
- Mater Misericordiae Hospital, Hospital Mackay, Mackay, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | | | - Casper Pretorius
- EndosQ Gastroenterologists, Mackay, Queensland, Australia
- Mackay Base Hospital, Mackay, Queensland, Australia
- Coral Sea Clinical Research Institute, Mackay, Queensland, Australia
| | - Ian S Brown
- Envoi Specialists Pathologists, Brisbane, Queensland, Australia
| | - Sally Bell
- Department of Gastroenterology, St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - A James M Daveson
- EndosQ Gastroenterologists, Mackay, Queensland, Australia
- Mater Misericordiae Hospital, Hospital Mackay, Mackay, Queensland, Australia
- College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia
- Coeliac and Immune Health Research Program, Wesley Medical Research, Brisbane, Queensland, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
- Coral Sea Clinical Research Institute, Mackay, Queensland, Australia
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Hirsch RD, Keung C, Con D, Vasudevan A, Van Langenberg DR, Niewiadomski O. Direct health care costs of managing perianal Crohn's Disease in a population based cohort. Scand J Gastroenterol 2022; 57:432-438. [PMID: 34932436 DOI: 10.1080/00365521.2021.2016944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Crohn's disease is a chronic condition that places a high health care cost burden. Perianal Crohn's disease (pCD) is a difficult phenotype to treat due to poorer response to medical and surgical therapies. No study has assessed if this translates to higher healthcare costs. The aim is to assess the cost of treating pCD and compare to the cost of non-perianal Crohn's disease (CD). METHODS This is a retrospective case-control cohort study in a population-based setting. The direct healthcare costs for patients with pCD were calculated over 12 months. Data was compared to the control group of non-perianal CD patients on biologic treatment, with the use of the Mann-Whitney rank test to assess significance. RESULTS 187 Crohn's patients were included (39 pCD, 148 CD). Per patient, annual cost was €17,779.19 and €17,576.86 respectively (p = .9391). Medications were responsible for the majority of cost at 78% and 92% of total cost in pCD and CD, respectively (€13,886.04 in pCD, and €16,007.10 in CD), of which biologics were the main driver. Surgical costs were higher in the pCD group due to a higher cost of luminal surgery (€2633.88 in pCD vs €209.79 in CD, p = .0270). CONCLUSION This is the first study to assess the cost of treating perianal Crohn's disease in a real-world population. Although the costs were similar overall to non-perianal Crohn's patients, the perianal cohort had higher surgical costs from luminal surgery. This demonstrates the potential to apply early intensive treatment to reduce future surgical cost.
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Affiliation(s)
- R D Hirsch
- Gastroenterology, Eastern Health, Monash University, Melbourne, Australia
| | - C Keung
- Gastroenterology, Eastern Health, Monash University, Melbourne, Australia
| | - D Con
- Gastroenterology, Eastern Health, Monash University, Melbourne, Australia
| | - A Vasudevan
- Gastroenterology, Eastern Health, Monash University, Melbourne, Australia
| | - D R Van Langenberg
- Gastroenterology, Eastern Health, Monash University, Melbourne, Australia
| | - O Niewiadomski
- Gastroenterology, Eastern Health, Monash University, Melbourne, Australia
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Laupland KB, Shekar K, Tabah A, Clement P, Edwards F, Ramanan M. Excess Burden of Critical Illness Related to Inflammatory Bowel Disease. Intern Med J 2021; 53:812-818. [PMID: 34932276 DOI: 10.1111/imj.15672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although inflammatory bowel disease (IBD) is associated with major morbidity and mortality, few studies have evaluated its associated burden of critical illness. AIMS We sought to examine the epidemiology and outcome of ICU admission among patients with IBD in north Brisbane, Australia. METHODS A population-based cohort design was utilized. All admissions to ICUs serving the Metro North Hospital and Health Service among adult residents during 2017-2019 were included. Data were obtained from ICU clinical information systems with linkages to statewide admissions and death registries. RESULTS Among 9,011 ICU admissions, 101 (1.1%) were among patients with IBD of which 57 (0.6%) and 44 (0.5%) had UC and CD, respectively. The incidence of ICU admission was 379, 1,336, 1,514, and 1,429 per 100,000 annually among those without IBD, CD, UC and IBD, respectively. Patients with IBD were at excess risk for admission across all age groups with women at highest risk under age 50 and men thereafter. The all cause 90-day case-fatality rates following ICU admission were not significantly different among patient groups and were 18%, 12%, 15%, and 12% for CD, UC, IBD, and non-IBD, respectively. However, as compared to non-IBD patients, those with CD (151.8 vs. 39.4 per 100,000; RR 3.85; 95% CI, 1.25-9.02; p=0.013); UC (159.4 vs 39.4 per 100,000; RR 4.05; 95% CI, 1.48-8.84; p=0.005), and IBD 155.6 vs 39.4 per 100,000; RR 3.95; 95% CI, 1.96-7.10; p=0.002) were at significantly higher risk for mortality. CONCLUSIONS Patients with IBD suffer a major burden of critical illness. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kevin B Laupland
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kiran Shekar
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Intensive Care Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Alexis Tabah
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Intensive Care Unit, Redcliffe Hospital, Redcliffe, Queensland, Australia
| | - Pierre Clement
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Felicity Edwards
- Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Mahesh Ramanan
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,Intensive Care Unit, Caboolture Hospital, Caboolture, Queensland, Australia
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Prevalence of inflammatory bowel disease in the Australian general practice population: A cross-sectional study. PLoS One 2021; 16:e0252458. [PMID: 34043730 PMCID: PMC8158877 DOI: 10.1371/journal.pone.0252458] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 05/14/2021] [Indexed: 12/31/2022] Open
Abstract
The burden of inflammatory bowel disease (IBD) in Australia is increasing but national data about the current prevalence are limited. We aimed to estimate the prevalence of IBD (including Crohn’s disease, ulcerative colitis and unspecified IBD) as well as Crohn’s disease and ulcerative colitis separately in a general practice population in Australia. We also assessed risk factors associated with Crohn’s disease and ulcerative colitis. We conducted a cross-sectional study using data from MedicineInsight, a national database of general practice electronic health records, from 1 July 2017 to 30 June 2019. The prevalence of IBD was calculated and stratified by sociodemographic characteristics. Logistic regression analysis was conducted to assess risk factors associated with Crohn’s disease and ulcerative colitis. The study comprised 2,428,461 regular patients from 481 practices. The estimated crude prevalence of IBD was 653 per 100,000 patients; Crohn’s disease was 306 per 100,000 and ulcerative colitis was 334 per 100,000. Males were independently associated with a lower risk of Crohn’s disease (OR: 0.86; 95% CI: 0.81, 0.90) but a greater risk of ulcerative colitis (OR: 1.12; 95% CI: 1.06, 1.17) than females. Compared to non-smokers, patients who were current smokers were associated with a greater risk of Crohn’s disease (OR: 1.13; 95% CI: 1.04, 1.23) but a lower risk of ulcerative colitis (OR: 0.52; 95% CI: 0.47, 0.57). Other factors positively associated with both Crohn’s disease and ulcerative colitis were age (≥ 25 years), non-Indigenous status and socioeconomic advantage. Our findings provide a current estimate of the prevalence of IBD, Crohn’s disease and ulcerative colitis in a large national general practice population in Australia and an assessment of the factors associated with Crohn’s disease and ulcerative colitis. These data can assist in estimating the health burden and costs, and planning for health services.
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Pudipeddi A, Liu J, Kariyawasam V, Borody TJ, Cowlishaw JL, McDonald C, Katelaris P, Chapman G, Corte C, Lemberg DA, Lee CH, Keshava A, Napoli J, Clancy R, Chan W, Paramsothy S, Leong R. High prevalence of Crohn disease and ulcerative colitis among older people in Sydney. Med J Aust 2021; 214:365-370. [PMID: 33502004 DOI: 10.5694/mja2.50910] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To determine the age-standardised prevalence of inflammatory bowel disease (IBD) in a metropolitan area of Sydney, with a focus on its prevalence among older people. DESIGN, SETTING Population-based epidemiological study of people with IBD in the City of Canada Bay, a local government area in the inner west of Sydney, during 1 March 2016 - 10 November 2016. PARTICIPANTS Patients diagnosed with confirmed IBD according to the Copenhagen or revised Porto criteria. MAIN OUTCOME MEASURES Crude prevalence of IBD, including Crohn disease and ulcerative colitis; age-standardised prevalence of IBD, based on the World Health Organization standard population; prevalence rates among people aged 65 years or more. RESULTS The median age of 364 people with IBD was 47 years (IQR, 34-62 years); 185 were women (50.8%). The crude IBD prevalence rate was 414 cases (95% CI, 371-456 cases) per 100 000 population; the age-standardised rate was 348 cases (95% CI, 312-385 cases) per 100 000 population. The age-standardised rate for Crohn disease was 166 cases (95% CI, 141-192 cases) per 100 000 population; for ulcerative colitis, 148 cases (95% CI, 124-171 cases) per 100 000 population. The IBD prevalence rate in people aged 65 years or more was 612 cases (95% CI, 564-660 cases) per 100 000, and for those aged 85 years or more, 891 cases (95% CI, 833-949 cases) per 100 000; for people under 65, the rate was 380 cases (95% CI, 342-418 cases) per 100 000. CONCLUSIONS We found that the prevalence of confirmed IBD in a metropolitan sample was highest among older people. Challenges for managing older patients with IBD include higher rates of comorbid conditions, polypharmacy, and cognitive decline, and the immunosuppressive nature of standard therapies for IBD.
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Affiliation(s)
| | - Jeffrey Liu
- Concord Repatriation General Hospital, Sydney, NSW
| | | | | | | | | | | | | | - Crispin Corte
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Albert Hospital, Sydney, NSW
| | | | - Cheng H Lee
- Children's Hospital at Westmead, Sydney, NSW
| | - Anil Keshava
- Concord Repatriation General Hospital, Sydney, NSW
| | | | | | - Webber Chan
- Concord Repatriation General Hospital, Sydney, NSW
| | | | - Rupert Leong
- Concord Repatriation General Hospital, Sydney, NSW
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The Antioxidant and Anti-Inflammatory Effects of Quercus brantii Extract on TNBS-Induced Ulcerative Colitis in Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3075973. [PMID: 33505492 PMCID: PMC7808820 DOI: 10.1155/2021/3075973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/15/2020] [Accepted: 12/19/2020] [Indexed: 12/16/2022]
Abstract
Objectives Ulcerative colitis is a common subtype of persistent inflammatory bowel disease with high morbidity consequences. Despite unknown definite pathogenesis, multiple anti-inflammatory medications are used for its treatment. Traditionally, Quercus brantii (QB), mostly available in the Middle East, has been used for gastrointestinal disorders. Other beneficial effects associated with QB include reduction of oxidative stress, inflammations, homeostatic instability, and improvement in clinical conditions. Materials and Methods This experimental study was designed to assess the possible therapeutic effects of QB on UC and compare its effects with those of sulfasalazine. Of the 70 Wistar rats clustered in seven groups, ten received only alcohols and sixty were confirmed to be suffering from trinitrobenzene sulfonic acid- (TNBS-) induced colitis. Four groups received different dosages of QB extract via oral and rectal routes, one received sulfasalazine, and the other remaining two groups received nothing. The effects of QB were evaluated by assessing macroscopic and histologic scoring, measuring inflammatory mediators, and determining oxidative stress markers. Results Comparing to the untreated TNBS-induced control groups, QB-treated groups showed a dose- and route-dependent improvement comparable with sulfasalazine. Treating rats with QB reduced the microscopic and macroscopic damage, decreased TNF-α, IL-6, NO, MPO activity, and MDA content, increased superoxide dismutase (SOD) activity, and reduced body weight loss. Conclusions Our data recommended the anti-inflammatory and antioxidant effects of QB extract in a dose-dependent manner.
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