What Have We Learnt about the Role of the Environment and Natural Course of IBD in the New Millennium? 20-Year Follow-Up of the IBSEN Cohort

Abstract

The incidence and prevalence of IBD, both Crohn's disease (CD) and ulcerative colitis (UC), have increased in recent years, especially in industrialized countries. Still, the etiology of IBD remains largely unknown. Most research on IBD before the 1990s was conducted on selected patient populations. Selected patient populations are likely to introduce important bias and limit the interpretation and generalizability. The inclusion of both incident and prevalent cases or the inclusion of incident cases over long periods of time (decades) might also introduce bias due to changes in treatment regimens and socioeconomic factors over timer (time-trend bias). Consequently, the choice of a well-characterized population-based inception cohort provides the best opportunity to describe the natural course of a disease. The IBSEN (Inflammatory Bowel Disease in South-Eastern Norway) study followed a large population-based cohort of newly diagnosed IBD patients for 20 years and has contributed significantly to the knowledge of the natural course of IBD.

Cholinergic immunomodulation in inflammatory bowel diseases

“…The incidence and prevalence of IBD have increased in recent years, especially in industrialized countries ( Moum et al., 2014 ). Differences in diagnostic resources and investments into healthcare indubitably affect the diagnosis of IBD, which may explain why low income countries report lower IBD incidence rates.…”

Targeting desmosomal adhesion and signalling for intestinal barrier stabilization in inflammatory bowel diseases—Lessons from experimental models and patients

“…2,3 While the incidence of IBD (especially CD) has stabilized following several decades of growth in North America and Europe, there appears to be a steady rise in its incidence in developing countries. [4][5][6] The onset of IBD usually occurs during young adulthood irrespective of its subtype. CD can affect all parts of the gastrointestinal tract from the oral cavity to the anus, and is characterized by transmural inflammation and epithelioid granulomas within the gut wall.…”

“…Inflammatory bowel diseases (IBD) are broadly classified as either ulcerative colitis (UC), Crohn’s disease (CD) 1 or are IBD‐unclassified (IBDU) when they share features of both UC or CD 2,3 . While the incidence of IBD (especially CD) has stabilized following several decades of growth in North America and Europe, there appears to be a steady rise in its incidence in developing countries 4‐6 . The onset of IBD usually occurs during young adulthood irrespective of its subtype.…”

Tolerance Limits, Self-understanding, and Stress Resilience in Integrative Recovery of Inflammatory Bowel Disease

“…The Inflammatory Bowel South-Eastern Norway study group has published epidemiological results of a 20-year follow-up in IBD showing patterns of disease development 8–10. The patient group with Crohn disease (CD) scores significantly lower on the general health and vitality dimensions after 10-year follow-up 11.…”