Increasing Global Incidence and Prevalence of Pediatric Inflammatory Bowel Disease

pediatric stomach exam
Investigators assessed geographic and longitudinal trends in the incidence and prevalence of pediatric-onset inflammatory bowel disease.

The incidence and prevalence of pediatric inflammatory bowel disease (IBD) is increasing globally, according to a study published in Gastroenterology.

While previous studies have demonstrated an increasing incidence and prevalence of IBD among both children and adults internationally, data are lacking on the epidemiology of IBD in industrializing and newly industrialized countries. In addition, the global epidemiology of IBD in children and adolescents remains understudied, particularly among those with very early-onset IBD (VEO-IBD).

Therefore, researchers evaluated the global trends in the incidence and prevalence of IBD diagnosed in patients aged less than 21 years by systematically reviewing the literature from January 2010 to February 2020. They identified population-based studies that reported the incidence and/or prevalence of IBD, Crohn disease, ulcerative colitis, and/or IBD-unclassified, as well as a previously published systematic reviews that included data from studies published before 2000.

In total, 131 studies from 48 countries were included. Researchers found the incidence and prevalence of pediatric-onset IBD to be highest in Canada, Northern Europe, New Zealand, and North America and lowest in Southern Europe, Africa, Asia, and the Middle East. Incidence of pediatric IBD in North America per 100,000 person-years ranged from 2.4 to 15.4.

Among studies evaluating trends over time, 84% (31/37) of studies reported significant increases in incidence of IBD and all (7/7) reported significant increases in prevalence. The data on the incidence and prevalence of VEO-IBD was limited to countries with historically high rates of IBD.

The incidence of Crohn disease was higher than ulcerative colitis in nearly all regions, among the 83 studies reporting on this, with the ratio of Crohn disease vs ulcerative colitis being approximately 2-3:1.

Investigators note any conclusions drawn from their review were limited by the quality of studies included; heterogeneity was present among reported age groups.

“Rates of pediatric-onset IBD continue to rise around the world and data are emerging from regions where it was not previously reported,” the researchers concluded. “Future research should design population-based cohorts that can be used to describe the epidemiology of IBD in these regions and understand the role of changing environmental risk factors on the risk of IBD in children.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Kuenzig ME, Fung SG, Marderfeld L, et al. Twenty-first century trends in the global epidemiology of pediatric-onset inflammatory bowel disease: systematic review. Gastroenterol. Published online January 5, 2022. doi: 10.1053/j.gastro.2021.12.282