Natural history of inflammatory bowel disease: a comparison between the East and the West

Abstract

Over the past decades, there has been a rapid increase in the incidence and prevalence of inflammatory bowel disease (IBD) in Asia. The natural history of IBD in Asian patients could be different from that in Western patients due to variations in disease phenotypes and genotypes as well as the healthcare environment between the 2 populations. To adequately cope with this disease, it is important to fully understand the potential differences in its natural history among different populations. In this review, we evaluated the differences in the clinical course of IBD between Asian and Western patients with regards to phenotypic progression, hospitalization, major surgery, risk of colorectal cancer, and mortality, mainly based on the results of population-based studies. The findings of our narrative review suggest that the clinical course of Asian patients with IBD, especially ulcerative colitis, is better than that of Western patients, as indicated by the lower rates of major surgery and hospitalization. In addition, similar to Western patients, the clinical course of Asian patients with IBD has been improving as evidenced by the decreasing rates of disease behavior progression (in Crohn' s disease), hospitalization, and major surgery.

Which biologic agents increase perioperative complications in patients with inflammatory bowel disease?

“…1 Nevertheless, certain patient group with aggressive disease course required IBD-related intestinal surgery in real world setting. 2,3 The perioperative complications could be increased in patients with previous corticosteroid use, malnutrition, intra-abdominal abscesses, and previous surgical history. 4 Also, the impact of biologic agents treatment on perioperative complications were investigated in many previous studies.…”

“…The medical treatment of patients with inflammatory bowel disease (IBD) has changed over the last decades with a significant increase in use of biologic agents, including anti-tumor necrosis factor (TNF)-α inhibitors, anti-α4β7-integrin inhibitors, and anti-interleukin 12/23 inhibitors [ 1 ]. Nevertheless, certain patient group with aggressive disease course required IBD-related intestinal surgery in real world setting [ 2 , 3 ]. The perioperative complications could be increased in patients with previous corticosteroid use, malnutrition, intra-abdominal abscesses, and previous surgical history [ 4 ].…”

Bioactive Components and Potential Mechanism Prediction of Kui Jie Kang against Ulcerative Colitis via Systematic Pharmacology and UPLC-QE-MS Analysis

“…UC is a common diffuse, nonspecific, and recurrent inflammatory disease of the rectum and colon mucosa and submucosa with high rates of relapse and canceration [ 3 ]. The incidence of UC has recently increased [ 4 ] with over 6.8 million cases having been reported worldwide [ 5 ]. Moreover, the age of onset tends to be 20–40 years old and can also be seen in children or the elderly [ 3 ].…”

Is primary sclerosing cholangitis with inflammatory bowel disease different between patients in the East and West?

“…This difference between East and West can be confirmed not only in PSC but also in the clinical course of IBD. Song and Yang [ 5 ] reported racial differences in disease phenotype and genotype, high prevalence of infectious diseases, and medication response/adverse events between IBD patients in the East and West. Additional research on PSC-IBD in Asia is needed as the few studies available limit the comparative analyses that can be performed.…”