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Cases of IBD are on the rise, according to new researcher. Getty Images
  • Researchers have found that IBD may be more common than previously realized.
  • People with IBD are more likely to get colorectal cancer.
  • An estimated 3 million Americans have IBD, according to the CDC.

There are 3 times as many people living with inflammatory bowel disease (IBD) than previously estimated, according to new research presented Sunday at United European Gastroenterology (UEG) Week, Barcelona 2019.

Not only do more people have IBD, they’re also at greater risk of developing colorectal cancer (CRC), according to the research.

Researchers at Sandwell and West Birmingham hospitals NHS Trust and the University of Birmingham examined IBD cases from 2000 to find accurate data on ulcerative colitis (UC) and Crohn’s disease (CD) prevalence in the UK.

“There are two common types of IBD, Crohn’s disease and ulcerative colitis. The main difference between the two is that while ulcerative colitis affects the large intestine [colon], Crohn’s disease can affect any part of the digestive tract,” explained Dr. Ahmad Kamal, associate chief of gastroenterology and vice chair of internal medicine at Santa Clara Valley Medical Center.

By utilizing data from The Health Improvement Network (THIN), a nationally representative UK primary care database, they discovered new evidence showing that IBD prevalence is 3 times higher than previously reported, with UC increasing by 55 percent and CD by 83 percent between 2000 and 2017.

The findings also suggest that from 2017 to 2025, IBD prevalence will continue to increase significantly.

“The link with ulcerative colitis was found to be significant with a 39 percent increased risk of [colorectal cancer] in those with IBD,” said Dr. Dominic King, from the University of Birmingham who presented the findings at UEG Week.

“With increasing levels of IBD and this risk, it is important that clinicians and patients are aware and ensure patients have follow-up and that surveillance takes place,” he added.

In 2015, an estimated 3 million U.S. adults reported an IBD diagnosis, according to the Centers for Disease Control and Prevention (CDC) — a significant increase from just 2 million adults in 1999.

“Our study suggests that IBD prevalence is likely to rise substantially over the next decade. As there is currently no known cure for IBD, patients will often need complex and costly treatments throughout their lives. This predicted rise in prevalence may place an even greater strain on already overburdened healthcare systems,” said King in a statement.

According to Dr. Loren Brook, assistant professor at the University of Cincinnati College of Medicine, and a UC Health physician, IBD is usually life-long.

“It would be extremely rare to ever stop needing treatment. Most patients are maintained on some medications from disease onset throughout life,” Brook said.

However, he emphasized that there are many medications effective at managing symptoms: “These range from relatively minor anti-inflammatory drugs such as oral mesalamine to immune-suppressing medications such as Remicade or steroids.”

Kamal added that no one knows for sure why IBD prevalence is rising worldwide, but it may be related to industrialization and urbanization.

“Living in rural areas may cause colonization of the intestinal tract with bacteria and parasites that prevent the body’s immune system from attacking itself,” he said.

According to the CDC, certain groups are more at risk of developing IBD than others.

  • Ulcerative colitis is more common in ex-smokers and nonsmokers, but Crohn’s disease is more frequent among smokers.
  • IBD is more frequent in developed countries and more commonly seen in urban areas compared to rural communities.
  • Diet, oral contraceptives, and childhood infections have been suggested, but not proven, to play a role in developing IBD.

“Risk factors for inflammatory bowel disease (IBD) include location, age, smoking, family history, and ethnicity. IBD is more common in the Western hemisphere. Crohn’s disease and ulcerative colitis more often present at less than 30 years of age, although Crohn’s may have a second peak in the sixth decade,” said Dr. David Shocket, director of gastroenterology at MedStar Washington Hospital Center.

Also, Shocket explained that “up to 28 percent of newly diagnosed patients will have a first-degree relative with inflammatory bowel disease. IBD is more common in Caucasians although the incidence is rising in minorities.”

“Certain groups of people with IBD find that specific foods will trigger their symptoms which include abdominal pain, diarrhea, bloating and/or symptoms of flares,” said Brook.

He emphasized that foods high in sugar or some artificial sweeteners can cause diarrhea and irritation of the colon that may mimic or progress to a flare up.

“Along with these things, food high in lactose [can] also cause many of the same symptoms of flares especially in patients who have a lactose intolerance at baseline.”

He added that people living with IBD should avoid certain foods like raw vegetables, nuts, or grains which contain insoluble fibers, and “excess alcohol and caffeine are common triggers that patients report.”

“Regular exercise, mindfulness-based stress reduction techniques, and avoidance of certain food triggers may help patients manage symptoms,” said Kamal.

Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) are particular carbohydrates and sugar alcohols that are poorly absorbed by the body, which can cause abdominal pain.

FODMAPs can occur in foods naturally or as an additive.

“Some patients with IBS respond to a low-FODMAP diet. Unfortunately, there are no known diet changes that reduce the amount of inflammation in inflammatory bowel disease,” said Kamal.

“While patients are having a flare of disease, they may find that reducing alcohol, caffeine, dairy, and fiber consumption makes them more comfortable,” he added.

New research finds the incidence of irritable bowel disease (IBD) is 3 times greater than previously thought. IBD is a chronic condition that’s also a risk factor for colorectal cancer.

This disease is affecting growing numbers of people worldwide and is projected to increase significantly from 2017 to 2025.

While there’s no cure for IBD, medications and lifestyle changes can help manage symptoms and reduce flare-ups.