• Diet
• Healthcare utilization
• IBD
• Immigrants
• Microbiota

• Humans
• Emigrants and Immigrants/statistics & numerical data
• Inflammatory Bowel Diseases/therapy
• Inflammatory Bowel Diseases/ethnology
• Inflammatory Bowel Diseases/epidemiology
• Inflammatory Bowel Diseases/diagnosis
• Incidence

• Asia
• IBD
• IBD in India
• epidemiology
• paediatric IBD
• very early-onset IBD

• diet
• environmental factors
• inflammatory bowel disease
• paediatric

• Child
• Humans
• Anti-Bacterial Agents/adverse effects
• Colitis, Ulcerative/etiology
• Colitis, Ulcerative/epidemiology
• Crohn Disease/epidemiology
• Crohn Disease/etiology
• Inflammatory Bowel Diseases/etiology
• Inflammatory Bowel Diseases/epidemiology
• Risk Factors
• Social Class
• Sugar-Sweetened Beverages/adverse effects
• Tobacco Smoke Pollution/adverse effects

• APP2009340 National Health and Medical Research Council (NHMRC) Leadership Research Fellowship

• Environment
• Epidemiology
• Immigration
• Inflammatory bowel disease

• Crohn’s disease (CD)
• inflammatory bowel disease (IBD)
• infliximab
• plant-based diet (PBD)
• ulcerative colitis (UC)

• Humans
• Retrospective Studies
• Incidence
• New Zealand/epidemiology
• Inflammatory Bowel Diseases/therapy
• Inflammatory Bowel Diseases/drug therapy
• Colitis, Ulcerative/epidemiology
• Colitis, Ulcerative/therapy
• Colitis, Ulcerative/complications
• Adrenal Cortex Hormones/therapeutic use
• Biological Products/therapeutic use

• Humans
• Asian People
• Colitis, Ulcerative/epidemiology
• Colitis, Ulcerative/ethnology
• Incidence
• Inflammatory Bowel Diseases/epidemiology
• Inflammatory Bowel Diseases/ethnology
• Phenotype
• South Asian People/statistics & numerical data

• Butyrate-producing microbes
• Clostridia
• Gut-taste receptor
• Inflammatory bowel disease
• Intestinal PPAR-γ
• Taste receptor type 1 member 3
• Western diet
• mTOR signaling

• NRF-2021R1A2C3010280 Ministry of Education
• NRF-2013M3A9D5072550 Institute for Information and Communications Technology Promotion

• CROHN'S DISEASE
• INFLAMMATORY BOWEL DISEASE
• OBESITY
• ULCERATIVE COLITIS

• Asia
• epidemiology
• immigrants
• inflammatory bowel disease

Over the last decade, there has been extensive evidence that patients with inflammatory bowel disease from minority communities in the UK receive less than optimal care. In none of the studies has the role of surgery in the management of acute and severe ulcerative colitis been considered in any detail. A freedom of information (FOI) request was sent to 14 NHS Trusts in England, which serve significant South Asian populations. Details of the type of surgery patients from the South Asian and White British communities received between 2021 and 2020 were requested. Detailed responses were obtained from eight Trusts. Four hundred and ten White British patients underwent surgery for ulcerative colitis over this period at these eight Trusts, together with 67 South Asian patients. There was no statistically significant difference in the distribution across the types of surgery undergone by the two communities overall (χ² = 1.3, ns) and the proportions who underwent an ileo-anal anastomosis with pouch (z = −1.2, ns). However, within individual trusts, at the University Hospital Southampton NHS Foundation Trust, a significantly greater proportion of South Asian patients had an ileo-anal anastomosis with pouch compared to White British patients. At Cambridge University Hospitals NHS Foundation Trust, all 72 patients who underwent surgery for ulcerative colitis were White British. This study has shown that, in general, for patients with a severe flare of ulcerative colitis where medical treatment has failed and surgery is warranted, the nature of the procedures offered is the same in the White British and South Asian communities. However, of concern is the number of units with low volume procedures. For most Trusts reported in this study, the overall number of Ileo-anal pouch anastomosis or anastomosis of ileum to anus procedures performed over a number of years was substantially below that required for a single surgeon to achieve competence. These findings reinforce the argument that inflammatory bowel disease surgery should be performed in a limited number of high-volume centres rather than across a wide range of hospitals so as to ensure procedures are carried out by surgeons with sufficient and on-going experience.

• epigenetics
• gut dysbiosis
• immunomodulation
• inflammation
• inflammatory bowel disease

• Chinese
• Crohn’s disease
• South Asian
• epidemiology
• ethnicity
• incidence
• inflammatory bowel disease
• ulcerative colitis

• Northbridge Chair in Inflammatory Bowel Diseases

• Asian
• Crohn's disease
• Thailand
• inflammatory bowel disease
• ulcerative colitis

• Coeliac Disease
• Crohn’s Disease
• Ethnic minority
• Experiences
• Inflammatory Bowel Disease
• Irritable Bowel Syndrome
• Systematic scoping review
• Ulcerative Colitis

• Diet
• Ethnicity
• Humans
• Minority Groups

• BCR2147 Bowel Research UK

• Inflammatory bowel disease [IBD]
• dietary patterns
• disease course

• Crohn's colitis
• Crohn's disease
• epidemiology
• inflammatory bowel disease
• ulcerative colitis

• Adolescent
• Adult
• Age Factors
• Aged
• Child
• Child, Preschool
• Cohort Studies
• Colitis, Ulcerative/ethnology
• Crohn Disease/ethnology
• Denmark/epidemiology
• Emigrants and Immigrants/statistics & numerical data
• Family Characteristics/ethnology
• Female
• Humans
• Incidence
• Infant
• Infant, Newborn
• Male
• Middle Aged
• Registries
• Risk Assessment
• Time Factors
• White People/statistics & numerical data
• Young Adult

• Epidemiology
• Ethnicity
• Inflammatory bowel disease
• Smoking

• Burden
• Crohn's disease
• epidemiology
• inflammatory bowel disease
• prevalence
• ulcerative colitis

• Adolescent
• Child
• Colitis, Ulcerative
• Crohn Disease/epidemiology
• Female
• Humans
• Incidence
• Inflammatory Bowel Diseases/epidemiology
• Male
• Prevalence

Epidemiological associations have implicated factors associated with Westernization, including the Western diet, in the development of inflammatory bowel disease (IBD). The role of diet in IBD etiopathogenesis, disease control and symptom management remains incompletely understood. Few studies have collected data on the dietary habits of immigrant populations living with IBD. Our aim was to describe the dietary practices and beliefs of British South Asians with IBD.

A 30-item questionnaire was developed and consecutively administered to 255 British South Asians with IBD attending gastroenterology clinics in the United Kingdom.

Fifty-one percent of participants believed diet was the initiating factor for their IBD and 63% felt diet had previously triggered disease relapse. Eighty-nine percent avoided certain dietary items in the belief that this would prevent relapse. The most commonly avoided foods and drinks were spicy and fatty foods, carbonated drinks, milk products, alcohol, coffee, and red meat. A third of patients had tried a whole food exclusion diet, most commonly lactose- or gluten-free, and this was most frequently reported amongst those with clinically active IBD (P = 0.02). Almost 60% of participants avoided eating the same menu as their family, or eating out, at least sometimes, to prevent IBD relapse.

British South Asians with IBD demonstrate significant dietary beliefs and food avoidance behaviors with increased frequency compared to those reported in Caucasian IBD populations. Studies in immigrant populations may offer valuable insights into the interaction between diet, Westernization and cultural drift in IBD pathogenesis and symptomatology.

• Crohn disease
• Diet
• Ethnic groups
• Inflammatory bowel disease
• Ulcerative colitis

• Asia/epidemiology
• Humans
• Inflammatory Bowel Diseases/diagnosis
• Inflammatory Bowel Diseases/epidemiology
• Inflammatory Bowel Diseases/therapy
• Medically Underserved Area
• Resource Allocation

• South Asian
• ethnicity
• inflammatory bowel disease
• migration
• phenotype

• Crohn’s disease
• disease phenotype
• tobacco smoking
• ulcerative colitis

• Colitis
• Drug discovery
• Irritable bowel diseases
• Medicinal plants

• IBD clinical
• epidemiology
• surgery for IBD
• ulcerative colitis

• Adolescent
• Adrenal Cortex Hormones/therapeutic use
• Adult
• Colectomy/statistics & numerical data
• Colitis, Ulcerative/drug therapy
• Colitis, Ulcerative/surgery
• Disease Progression
• Female
• Follow-Up Studies
• Hospitalization/statistics & numerical data
• Humans
• Immunosuppressive Agents/therapeutic use
• Male
• Mercaptopurine/analogs & derivatives
• Mercaptopurine/therapeutic use
• Prognosis
• Republic of Korea
• Risk Factors
• Severity of Illness Index
• Time Factors
• Tumor Necrosis Factor-alpha/antagonists & inhibitors
• Young Adult

• Crohn's disease
• IBD
• epidemiology
• inflammatory bowel disease
• ulcerative colitis

The national registry for inflammatory bowel disease (IBD) was designed to study epidemiology and prescribing pattern of treatment of IBD in India.

A multicenter, cross-sectional, prospective registry was established across four geographical zones of India. Adult patients with ulcerative colitis (UC) or Crohn’s disease (CD) were enrolled between January 2014 and December 2015. Information related to demographics; disease features; complications; and treatment history were collected and analyzed.

A total of 3,863 patients (mean age, 36.7 ± 13.6 years; 3,232 UC [83.7%] and 631 CD [16.3%]) were enrolled. The majority of patients with UC (n = 1,870, 57.9%) were from north, CD was more common in south (n = 348, 55.5%). The UC:CD ratio was 5.1:1. There was a male predominance (male:female = 1.6:1). The commonest presentation of UC was moderately severe (n = 1,939, 60%) and E2 disease (n = 1,895, 58.6%). Patients with CD most commonly presented with ileocolonic (n = 229, 36.3%) inflammatory (n = 504, 79.9%) disease. Extraintestinal manifestations were recorded among 13% and 20% of patients in UC and CD respectively. Less than 1% patients from both cohorts developed colon cancer (n = 26, 0.7%). The commonly used drugs were 5-aminosalicylates (99%) in both UC and CD followed by azathioprine (34.4%). Biologics were used in only 1.5% of patients; more commonly for UC in north and CD in south.

The national IBD registry brings out diversities in the 4 geographical zones of India. This will help in aiding research on IBD and improving quality of patient care.

• Colitis, ulcerative
• Crohn disease
• India
• Inflammatory bowel disease
• National registry

• Crohn’s disease
• anti-inflammatory
• biologics
• inflammatory bowel diseases
• natural products drugs
• small molecule drugs
• ulcerative colitis

• Emigrants and immigrants
• access
• and evaluation
• epidemiology
• healthcare quality
• immune system diseases
• public health

• Crohn’s disease
• diet
• inflammatory bowel disease
• ulcerative colitis

• butyrate
• oat bran
• ulcerative colitis
• β-glucan

The current epidemiology of inflammatory bowel disease (IBD) in the multi-ethnic United Kingdom is unknown. The last incidence study in the United Kingdom was carried out over 20 years ago.

To describe the incidence and phenotype of IBD and distribution within ethnic groups.

Adult patients (> 16 years) with newly diagnosed IBD (fulfilling Copenhagen diagnostic criteria) were prospectively recruited over one year in 5 urban catchment areas with high South Asian population. Patient demographics, ethnic codes, disease phenotype (Montreal classification), disease activity and treatment within 3 months of diagnosis were recorded onto the Epicom database.

Across a population of 2271406 adults, 339 adult patients were diagnosed with IBD over one year: 218 with ulcerative colitis (UC, 64.3%), 115 with Crohn's disease (CD, 33.9%) and 6 with IBD unclassified (1.8%). The crude incidence of IBD, UC and CD was 17.0/100000, 11.3/100000 and 5.3/100000 respectively. The age adjusted incidence of IBD and UC were significantly higher in the Indian group (25.2/100000 and 20.5/100000) compared to White European (14.9/100000, P = 0.009 and 8.2/100000, P < 0.001) and Pakistani groups (14.9/100000, P = 0.001 and 11.2/100000, P = 0.007). The Indian group were significantly more likely to have extensive disease than White Europeans (52.7% vs 41.7%, P = 0.031). There was no significant difference in time to diagnosis, disease activity and treatment.

This is the only prospective study to report the incidence of IBD in an ethnically diverse United Kingdom population. The Indian ethnic group showed the highest age-adjusted incidence of UC (20.5/100000). Further studies on dietary, microbial and metabolic factors that might explain these findings in UC are underway.

• Inflammatory bowel disease
• Ethnicity
• Epidemiology
• Incidence
• Phenotype

• Adult
• Asian People/statistics & numerical data
• Catchment Area, Health/statistics & numerical data
• Colitis, Ulcerative/ethnology
• Crohn Disease/ethnology
• Databases, Factual/statistics & numerical data
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Prospective Studies
• United Kingdom/epidemiology
• White People/statistics & numerical data

Migration is associated with changes in the incidence of diseases, often linked to new environmental exposures or movement away from such exposures. Studies are complicated by the time and length of migration and also by differences in the experience of second‐ and third‐generation migrants. South Asian people have migrated across the world. In this review, the incidence and prevalence of inflammatory bowel disease in these communities is considered, along with their potential role in future investigative studies of the diseases’ etiology.

• South Asian
• diaspora
• inflammatory bowel disease

The effect of smoking on the risk of developing inflammatory bowel diseases (IBD) may be heterogeneous across ethnicity and geography. Although trends in smoking for the general population are well described, it is unknown whether these can be extrapolated to the IBD cohort. Smoking prevalence trends specific to the global IBD cohort over time have not been previously reported. This is a systematic review of smoking prevalence specific to the IBD cohort across geography.

A systematic literature search was conducted on Medline and Embase from January 1^st 1946 to April 5^th 2018 to identify population-based studies assessing the prevalence of smoking at diagnosis in inception cohorts of Crohn’s disease(CD) or ulcerative colitis(UC). Studies that did not report smoking data from time of diagnosis or the year of IBD diagnosis were excluded. Prevalence of smoking in IBD was stratified by geography and across time.

We identified 56 studies that were eligible for inclusion. Smoking prevalence data at diagnosis of CD and UC was collected from twenty and twenty-five countries respectively. Never-smokers in the newly diagnosed CD population in the West has increased over the last two decades, especially in the United Kingdom and Sweden; +26.6% and +11.2% respectively. Never-smokers at CD diagnosis in newly industrialised nations have decreased over the 1990s and 2000s; China (-19.36%). Never-smokers at UC diagnosis also decreased in China; -15.4%. The former-smoker population at UC diagnosis in China is expanding; 11%(1990–2006) to 34%(2011–2013).

There has been a reduction in the prevalence of smoking in the IBD cohort in the West. This is not consistent globally. Although, smoking prevalence has decreased in the general population of newly industrialised nations, this remains an important risk factor with longer term outcomes awaiting translation in both UC and CD.

• Cohort Studies
• Colitis, Ulcerative/etiology
• Crohn Disease/etiology
• Global Health
• Humans
• Inflammatory Bowel Diseases/etiology
• Prevalence
• Risk Factors
• Tobacco Smoking/adverse effects
• Tobacco Smoking/epidemiology
• Tobacco Smoking/trends

• Department of Health

• Clinical
• Inflammatory bowel diseases
• Obesity
• Pathogenic relationships

• Autoimmunity
• Epidemiology
• Immigration
• Immune-mediated inflammatory diseases
• Population-based studies
• Systematic review

• Antibody
• Food allergy
• Immunomodulation
• Inflammatory bowel disease
• Intestine
• Plasma cells
• Tumors

• National Natural Science Foundation of China
• Natural Science Foundation of Beijing Municipality

• Crohn’s disease
• adaptive/acquired immune system
• diet/nutrition
• dysbiosis/dysbacteriosis)
• environment
• ethnicity
• gastrointestinal disorders
• genetics
• indeterminate colitis
• inflammation
• inflammatory bowel disease
• innate immune system
• intestinal microbiota
• rural lifestyle
• ulcerative colitis
• urbanization

• UL1 TR000445 NCATS NIH HHS
• U54 CA091408 NCI NIH HHS
• U54 CA091405 NCI NIH HHS
• R21 DK095186 NIDDK NIH HHS
• UL1 RR024975 NCRR NIH HHS

• Inflammatory bowel disease
• diet
• environment
• microbiome
• smoking

• Inflammatory bowel disease
• children
• early risk factors

Canada has among the highest incidence and prevalence of inflammatory bowel disease (IBD) in the world. After decades of rising incidence of IBD in Canada during the 20th Century, the prevalence of IBD in 2018 is 0.7% of the Canadian population. Forecasting models predict that prevalence of IBD will continue to rise to 1.0% of the population by 2030. In 2018, the number of Canadians living with IBD is approximately 270,000 and is predicted to rise to 403,000 Canadians in 2030. Inflammatory bowel disease affects all age groups with adolescents and young adults at highest risk of diagnosis. Canadians of all ethnicities are being diagnosed with IBD including known high-risk groups such as Ashkenazi Jews and offspring of South Asian immigrants who were previously thought to be low risk. Moreover, IBD has evolved into a global disease with rising incidence in newly industrialized countries in Asia and South America. The causes of IBD remain unsolved; however, the high rates of disease in Western countries and its emergence in newly industrialized countries suggest that environmental factors associated with urbanization, modernization, or Western diets may be pertinent to understanding the pathogenesis of the disease.

1. Canada continues to have among the highest prevalence of IBD in the world.

2. Today, approximately 270,000 Canadians live with IBD. By 2030 it is estimated that nearly 403,000 Canadians will have a diagnosis of IBD.

3. Inflammatory bowel disease has become a worldwide disease with increasing rates in Asia, Africa, and South America—continents where IBD was rarely diagnosed prior to 1990.

4. The causes of IBD are unknown, but the high rates of disease over the past 60 years in Western countries and the emergence of disease in developing countries suggest that factors associated with urbanization, modernization, or Western diets may be pertinent to understanding the pathogenesis of the disease.

5. Many of the leading hypotheses as to the causes of IBD tie in with alteration of the gut microbiome, the suite of organisms that reside in the bowel and maintain bowel health throughout life.

1. The incidence (the number of new diagnoses annually) of IBD rose throughout the 20th century in Canada and then stabilized at the turn of the 21st century.

2. The prevalence (the total number of diagnosed persons in the population) of IBD in Canada is among the highest in the world.

3. Today, 270,000 (0.7%, or 7 in 1000) Canadians are estimated to live with IBD. By 2030, that number is expected to rise to 403,000 Canadians (1% or 1 in 100).

4. Inflammatory bowel disease can be diagnosed at any age. However, the age groups that are most likely to be diagnosed are adolescents and young adults from 20 to 30 years of age.

5. Inflammatory bowel disease in Canada affects the lives of Canadians of all ethnicities, including known high-risk groups such as Ashkenazi Jews, and those thought previously to be at low risk, such as first-generation offspring of South Asian immigrants.

6. Canadian health policy makers will need to prepare the Canadian health care system for the rising burden of IBD.

7. As newly industrialized countries in Asia, Africa, and South America are transitioning to a Westernized society, IBD has emerged and its incidence in these countries is rising rapidly.

8. The gut microbiome includes microorganisms that maintain digestive health. Thus, changes in the microbiome, which may change the immune system’s response to triggers, may be important in initiating and perpetuating IBD.

9. A number of factors can alter the gut microbiome and early childhood may be a particularly important time such that breastfeeding, early life diet, use of antibiotics, infections, and other environmental exposures may impact the gut microbiome in such a way that facilitates developing IBD.

10. Smoking is associated with an increased risk and worsening disease course of Crohn’s disease. Quitting smoking is associated with an increased risk of developing ulcerative colitis. Therefore, never initiating smoking can mitigate the risk for IBD. Educational programs aimed at those at-risk for IBD should emphasize the risk of starting to smoke tobacco.

11. Modifying exposure to environmental risk factors associated with the Westernization of society (e.g., Western diet and lifestyles) may provide an avenue for reducing the risk of IBD in Canada and worldwide.

1. While the incidence of IBD appears to be stabilizing in some regions in Canada, IBD may be occurring more frequently in certain populations such as in children, South Asians, Ashkenazi Jews, and immigrants. Future research should focus on the changing demographics of IBD in Canada.

2. The prevalence of IBD will rise steadily over the next decade. To enable better health care system planning and to respond adequately to the increasing burden of IBD, ongoing surveillance of the epidemiology and health services utilization of IBD in Canada is necessary.

3. Most studies have focused on the mortality associated with IBD. Future research is necessary to assess health-adjusted life expectancy and overall life expectancy for those living with IBD.

4. Analyses of resources, infrastructure, and personnel need to be modeled into the future in order to prepare our health care system for the rising burden of IBD.

5. Research on the interaction between genes, microbes, and our environment will inform our understanding of the pathogenesis of IBD, information necessary to prevent IBD in the future.

• Epidemiology
• Incidence
• Inflammatory bowel disease
• Outcomes; Prevalence

• bacteria
• diet
• fecal microbiota transplantation
• gut microbiota
• helminths
• inflammatory bowel disease
• mycobiota
• virobiota

• Children
• Crohn’s disease
• Incidence
• Inflammatory bowel disease
• Inflammatory bowel disease-unclassified
• Ulcerative colitis

• Adolescent
• Child
• Child, Preschool
• Colitis, Ulcerative/epidemiology
• Crohn Disease/epidemiology
• Emigrants and Immigrants/statistics & numerical data
• Europe/epidemiology
• Global Health/statistics & numerical data
• Global Health/trends
• Humans
• Incidence
• Infant
• Infant, Newborn
• North America/epidemiology
• Risk Factors