Changing Patterns in the Epidemiology of Crohn Disease

Abstract

Crohn disease is a chronic inflammatory disorder that primarily affects the alimentary tract. It is an increasingly global health concern, with recent data indicating rising rates across many countries in the world, along with a growing prevalence in childhood. Numerous reports indicate that Crohn disease is no longer confined to Western countries, with many reports of diagnosis in other regions including less developed nations. Changes in dietary patterns, along with other environmental factors, appear to account for these recent changes in the patterns of Crohn disease epidemiology. The objective of this work was to review current available literature concerning the epidemiology of Crohn disease and to consider the possible roles of environmental factors that may be implicated in these changing patterns. Widespread data indicates increasing incidence of Crohn disease in many countries across the world. The reasons for these rapid changes in the epidemiology of Crohn disease are not clearly understood. However, environmental changes appear to the most important factors for these recent changes.

An overview of the bacterial contribution to Crohn disease pathogenesis

“…Several perinatal and postnatal factors including diet habits and early life exposure to drugs and vaccines have been claimed to be environmental factors associated with the increase in immunological diseases including CD (Alhagamhmad et al, 2015). Numerous reports demonstrate that environmental triggers, most notably diet, have profound effects on the gut microbiome and can influence microbiota composition, growth and shapes (Koropatkin et al, 2012;Carbonero et al, 2012;Sekirov et al, 2010).…”

“…CD is a complex heterogeneous disorder with the underlying aetiopathogenesis being multifactorial with genetic, immunologic, environmental and microbial factors contributing to the disease (Alhagamhmad et al, 2012). Evidence of the role of bacteria in CD pathogenesis was historically provided by the successful role of antibiotics in CD treatment (Greenbloom et al, 1997), with additional evidence provided by the success of faecal diversion in preventing disease relapse (Rutgeerts et al, 1991).…”

Enteral Nutrition in the Management of Crohn's Disease: Reviewing Mechanisms of Actions and Highlighting Potential Venues for Enhancing the Efficacy

“…In addition to the chronic and current incurable nature of CD, there is an increase in the global incidence and prevalence rates . Recent reports show that CD is no longer confined, as previously known, to the Western countries; rather, it is increasingly becoming more prevalent in other parts of the world with a concomitant rise in CD diagnoses among children . Changes in dietary habits along with the other environmental triggers are believed to account for the recent changes in the patterns of CD epidemiology …”

“…3 Recent reports show that CD is no longer confined, as previously known, to the Western countries; rather, it is increasingly becoming more prevalent in other parts of the world with a concomitant rise in CD diagnoses among children. 4 Changes in dietary habits along with the other environmental triggers are believed to account for the recent changes in the patterns of CD epidemiology. 4 Further challenges involved in the management of CD include the accompanying nutrition complications, including impairments in growth and development.…”

“…4 Changes in dietary habits along with the other environmental triggers are believed to account for the recent changes in the patterns of CD epidemiology. 4 Further challenges involved in the management of CD include the accompanying nutrition complications, including impairments in growth and development. 5 It has been reported that around 50% of CD patients may be underweight and stunted at the time of diagnosis.…”