The epidemiology of pediatric inflammatory bowel disease

Abstract

The global epidemiology of pediatric inflammatory bowel disease (IBD) is evolving rapidly: continuing to increase in areas with previously reported high incidence and prevalence and emerging in regions where it was either low or not reported. Yet, there remains a paucity of data on the epidemiology of IBD in many low- and middle-income countries. The pathogenesis of IBD is complex and is rooted in the interactions between a person's genetics, microbiome, environmental risk factors triggering an inappropriate response. Accordingly, many environmental risk factors studied in IBD (e.g., smoking, diet, air pollution) are believed to influence risk by modifying the intestinal microbiome. The rapid growth of IBD among children, their limited number of environmental exposures, and the role of early-life exposures in shaping the intestinal microbiome, coupled with differing risks across ethnocultural groups migrating from regions of low to high risk, provide important opportunities to understand the pathogenesis of IBD.