No abstract available.
Crohn Disease* ; Epidemiology*

Crohn Disease ; epidemiology ; surgery ; Humans

The epidemiology, genetics, and clinical manifestations of Crohn's disease (CD) vary considerably among geographic areas and ethnic groups. Thus, identifying the characteristics of Korean CD is important for establishing management strategies appropriate for Korean patients. Since the mid-2000s, many studies have investigated the characteristic features of Korean CD. The incidence and prevalence rates of CD have been increasing rapidly in Korea, especially among the younger population. Unlike Western data, Korean CD shows a male predominance and a lower proportion of isolated colonic disease. Perianal lesions are more prevalent than in Western countries. Genome-wide association studies have confirmed that genetic variants in TNFSF15, IL-23R, and IRGM, but not ATG16L1, are associated with CD susceptibility in the Korean population. Studies of the associations between genetic mutations and the clinical course of CD are underway. Although it has been generally accepted that the clinical course of Korean CD is milder than that in Western countries, recent studies have shown a comparable rate of intestinal resection in Korean and Western CD patients. An ongoing nationwide, hospital-based cohort study is anticipated to provide valuable information on the natural history and prognosis of Korean CD in the near future.
*Crohn Disease/diagnosis/epidemiology/therapy ; Diagnosis, Differential ; Female ; Humans ; Male ; Prognosis ; Republic of Korea/epidemiology

China ; Colitis, Ulcerative ; epidemiology ; etiology ; Crohn Disease ; epidemiology ; etiology ; Humans ; Inflammatory Bowel Diseases ; epidemiology ; etiology ; Sweetening Agents ; adverse effects

OBJECTIVE: To describe the distribution characteristics of inflammatory bowel disease among permanent residents in Yinzhou District, Ningbo City, and to understand the disease burden and development trend of inflammatory bowel disease in this area. METHODS: Using the retrospective cohort design, we collected the registration information of all permanent residents in the residents' health files of the Yinzhou Regional Health Information Platform from 2010 to 2020, and used electronic medical records to follow up their inflammatory bowel disease visits. A one-year wash-out period was set, and the patients who were diagnosed with the primary diagnosis for the first time after one year of registration were re-garded as new cases. The incidence density and 95% confidence interval (CI) of inflammatory bowel disease were estimated by Poisson distribution. RESULTS: From 2011 to 2020, a total of 1 496 427 permanent residents in Yinzhou District were included, of which 729 996 were male (48.78%). The total follow-up person-years were 8 081 030.82, and the median follow-up person-years were 5.41 [interquartile range (IQR): 5.29]. During the study period, there were 1 217 new cases of inflammatory bowel disease, of which males (624 cases, 51.27%) were more than females (593 cases, 48.73%). The total incidence density was 15.06/100 000 person-years (95%CI: 14.23, 15.93). Among all new cases, there were 1 106 cases (90.88%) of ulcerative colitis, with an incidence density of 13.69 per 100 000 person-years (95%CI: 12.89, 14.52); 70 cases (5.75%) of Crohn's disease, with an incidence density of 0.87 per 100 000 person-years (95%CI: 0.68, 1.09); and 41 cases (3.37%) of indeterminate colitis, with an incidence density of 0.51 per 100 000 person-years (95%CI: 0.36, 0.69). The median age of onset of ulcerative colitis was 50.82 years old (IQR: 18.77), with the highest proportion (15.01%) in the 45-49 years group. The incidence density of ulcerative colitis gradually increased with age, reaching a relatively high level in the 45-49 years group (20.53/100 000 person-years; 95%CI: 17.63, 23.78), followed by a slight increase. And the incidence density in the 65-69 years group was the highest (25.44/100 000 person-years; 95%CI: 20.85, 30.75), with a rapid decrease in the 75-79 years group. The median age of onset of Crohn's disease was 44.34 years (IQR: 33.41), with the highest proportion (12.86%) in the 25-29 years group. Due to the small number of new cases of Crohn's disease, the age distribution fluctuated greatly, with peaks both in young and old people. From 2011 to 2020, the incidence density of inflammatory bowel disease in Yinzhou District was at a low level from 2011 to 2013, and showed a rapid upward trend from 2014 to 2016, reaching a peak of 24.62 per 100 000 person-years in 2016 (95%CI: 21.31, 28.30), and slightly decreased in 2017-2020. CONCLUSION The incidence density of inflammatory bowel disease in Yinzhou District from 2011 to 2020 was at a relatively high level, and medical institutions and health departments need to pay attention to the burden of disease caused by it.
Adolescent ; Adult ; Chronic Disease ; Colitis, Ulcerative/epidemiology* ; Crohn Disease/epidemiology* ; Female ; Humans ; Incidence ; Inflammatory Bowel Diseases/epidemiology* ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND/AIMS: The incidence of Crohn's disease (CD) has been steadily increasing in Korea due to westernized life style and widely used imaging studies such as colonoscopy. There were few studies about the status of longterm trend of CD and intestinal tuberculosis (IT). Therefore, we aimed to evaluate the trend of CD and IT in Korea. METHODS: We retrospectively reviewed the medical records of newly diagnosed 65 patients with CD and 54 patients with IT at Chonnam National University Hospital between January 1998 and August 2007. RESULTS: Between 1998 and 2002, 16 and 40 patients were newly diagnosed as having CD and IT respectively, but between 2003 and 2007, 39 and 14 patients were newly diagnosed as having CD and IT respectively. CD patients (28.2+/-15.2 years) were younger than IT (46.2+/-18.5 years) (p=0.001). The male to female ratio of CD and IT were 2:1 and 1.1:1, respectively. The most common symptom of CD and IT was abdominal pain. Longitudinal ulceration, hyperemia, luminal narrowing, pseudopolyp, and cobble stone appearance were more common in CD than in IT (p<0.05). CONCLUSIONS: While the incidence of CD has increased, the incidence of IT has fallen over the last decade.
Adolescent ; Adult ; Age Factors ; Aged ; Crohn Disease/*diagnosis/*epidemiology/pathology ; Endoscopy, Gastrointestinal ; Female ; Humans ; Incidence ; Korea/epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Gastrointestinal/*diagnosis/*epidemiology/pathology

BACKGROUND/AIMS: Pediatric inflammatory bowel disease (IBD) has been increasing worldwide. The characteristics of pediatric-onset IBD have mainly been reported in Western countries. We investigated the clinical characteristics of pediatric IBD in Korea and compared these with the data from the 5-year European multicenter study of children with new-onset IBD (EUROKIDS registry). METHODS: Children who were diagnosed with IBD between July 1987 and January 2012 were investigated at five Korean university hospitals. Their clinical characteristics were retrospectively evaluated by medical record review. The results were compared with the EUROKIDS data. RESULTS: A total of 30 children with Crohn's disease (CD) and 33 children with ulcerative colitis (UC) were enrolled. In comparison with the EUROKIDS group, Korean pediatric IBD patients showed a male predominance (86.7% vs 59.2%, p=0.002 in CD; 75.8% vs 50%, p=0.003 in UC). Korean pediatric CD patients had a higher prevalence of terminal ileal disease (36.7% vs 16.3%, p=0.004) and perianal disease (33.3% vs 8.2%, p<0.001) than patients in the EUROKIDS group. Korean pediatric UC patients had a higher prevalence of proctitis than patients in the EUROKIDS group. CONCLUSIONS: Our results suggest that the characteristics of Korean pediatric IBD patients and European pediatric IBD patients may be different.
Adolescent ; Anus Diseases/complications/epidemiology/pathology ; Child ; Colitis, Ulcerative/complications/epidemiology/*pathology ; Crohn Disease/complications/epidemiology/*pathology ; Europe/epidemiology ; Female ; Humans ; Ileal Diseases/complications/epidemiology/pathology ; Male ; Prevalence ; Proctitis/epidemiology/etiology ; Registries ; Republic of Korea/epidemiology ; Retrospective Studies ; Sex Factors

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) with uncertain etiopathogenesis. CD can involve any site of gastrointestinal tract from mouth to anus and is associated with serious complications such as bowel stricture, perforation, abscess, and fistula formation. The incidence and prevalence rates of CD in Korea are still low compared with those of Western countries, but are rapidly increasing during the past decades. The diagnosis of CD is a challenging issue in some clinical situations and it is often difficult to differentiate CD from intestinal tuberculosis or Beh?et's enterocolitis which are more prevalent in Korea than in Western countries. Therefore, IBD Study Group of KASID has set out to establish the diagnostic guideline of CD in Korea. There is no single gold standard for the diagnosis of CD and diagnosis is made by clinical evaluation including detailed history, physical examination, and combination of endoscopic findings, histology, radiologic findings and laboratory investigations. The typical symptoms of CD are abdominal pain, diarrhea, and weight loss especially in late adolescence or early adulthood. Initial laboratory investigations include CBC, C-reactive protein, and serum chemistry. Ileocolonoscopy and biopsies are recommended as the first line procedures to establish the diagnosis. Typical endoscopic findings of CD are non-continuous distribution of longitudinal ulcers, cobblestone mucosal appearance, and aphthous ulcerations arranged in a longitudinal fashion. The evaluation of small bowel with small bowel follow-through is recommended for suspected CD to establish diagnosis and to determine the extent and location of disease. Focal and patchy chronic inflammation, focal crypt irregularity, and non-caseating granulomas are usual microscopic features of CD. This is the first Korean diagnostic guideline for CD and needs revision with further data on CD in Koreans.
Biopsy ; Blood Chemical Analysis ; Colonoscopy ; Crohn Disease/classification/*diagnosis/epidemiology ; Diagnostic Imaging ; Hematologic Tests ; Humans ; Remission, Spontaneous ; Severity of Illness Index

OBJECTIVES: With the increase in aging population in China, elderly Crohn's disease (CD) patients need to receive more attention. This study aims to explore the clinical characteristics and disease process of elderly onset CD (EOCD) patients in a single center. METHODS: From January 2002 to January 2022, a total of 221 patients with CD from the Seventh Medical Center of Chinese PLA General Hospital were enrolled. According to the Montreal CD classification standard, the patients were further divided into 4 groups: an EOCD group (≥60 years old, n=25), a middle age onset CD (MOCD) group (40-59 years old, n=46), a young onset CD (YOCD) group (17-40 years old, n=131), and a childhood onset CD (COCD) group (6-16 years old, n=19). We compared the clinical characteristics and long-term prognosis among them. RESULTS: Females were predominant in the EOCD group (15/25, 60%). The number of people without smoking in the EOCD group (80%) was lower than that in COCD group (100%), higher than that in the YOCD group (70.2%) and the MOCD group (69.6%) (all P<0.05). Patients with perianal diseases at diagnosis were rare in the EOCD group (0%), lower than that in the COCD group (21.1%) and the YOVD group (19.8%) (all P<0.05). Stenosis was the most common disease behavior in the EOCD group (63.0%), significantly higher than that in the COCD group (15.8%), the YOCD group (36.6%) and the MOCD group (43.5%) (all P<0.05). The EOCD group was easier to be misdiagnosed as tumor (24%), higher than that in the COCD group (0%), the YOCD group (6.9%) and the MOCD group (19.6%) (all P<0.05). The EOCD group was prone to comorbidities (52%), and 20% of them were complicated with multiple comorbidities (P<0.05). During the follow-up, the all-cause mortality of EOCD was 12%, and the CD-related mortality was 8%, which was significantly higher than the other groups (all P<0.05). The use of immunosuppressants in the EOCD group (4.8%) was lower than that in the COCD group (12.8%), the YOCD group (16.8%) and the MOCD group (16.1%), but there was no statistical significance among the 4 groups (P=0.467). In addition, there was no significant difference in the rate of intestinal resection among the 4 groups (P=0.062). CONCLUSIONS In EOCD patients, females were predominant, smoking was less common, and they were prone to comorbidity. At the initial stage of diagnosis, it is easy to be misdiagnosed as tumor, and the disease behavior mainly showed stricture type, less complicated with perianal diseases. During the follow-up, all-cause mortality and CD-related mortality of EOCD patients were significantly higher than those of the non-elderly onset CD patients.
Female ; Middle Aged ; Humans ; Aged ; Child ; Adult ; Adolescent ; Young Adult ; Crohn Disease/epidemiology* ; Prognosis ; Constriction, Pathologic ; Aging ; Hospitals, General

BACKGROUND/AIMS: Focally enhanced gastritis (FEG) has been suggested as a specific diagnostic marker for patients with Crohn's disease (CD). However, the usefulness of FEG for distinguishing CD from ulcerative colitis (UC) is uncertain and the incidence or prevalence of FEG for inflammatory bowel disease (IBD) patients in Korea has not been defined yet. In this study, we investigated the frequency of FEG and other gastric histological abnormalities in Korean patients with CD and UC. METHODS: We evaluated 37 patients with known CD, 43 patients with UC and 41 non-IBD control group; all underwent upper gastrointestinal endoscopy followed by biopsy from the antrum and the body. The pathology of the gastric biopsy specimens and the presence of Helicobacter pylori (H. pylori) were evaluated. FEG was characterized by a focal perifoveolar or periglandular inflammatory cell infiltrates. RESULTS: H. pylori positive gastritis was found in 10 of 37 (27.0%) of CD patients, in 16 of 43 (37.2%) of UC patients, and in 22 of 41 (53.7%) of non-IBD control group (p=0.054). In H. pylori-negative patients, FEG was found in 8 of 27 patients (29.6%) of CD patients, 6 of 27 (22.2%) patients with UC, and 2 of 9 (10.5%) of non-IBD control group (p=0.324). CONCLUSIONS: In H. pylori-negative patients, there was no statistically significant difference in the occurrence of FEG among CD, UC and control groups in Korea.
Adult ; Colitis, Ulcerative/*diagnosis/etiology/pathology ; Crohn Disease/*diagnosis/etiology/pathology ; Female ; Gastritis/epidemiology/*pathology ; Gastroscopy ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Upper Gastrointestinal Tract/pathology