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Advances in epidemiology and diagnosis of inflammatory bowel diseases

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Abstract

The etiology of chronic inflammatory bowel diseases (IBD) remains unknown. Understanding IBD epidemiology helps to identify at-risk individuals, to appreciate the changing demographic profile of IBD, and to interpret theories of IBD pathogenesis. This article reviews recent advances in epidemiology and diagnostics. The importance of Clostridium difficile is highlighted. State-of-the-art IBD diagnostic modalities include serology, fecal markers, and advanced radiologic or endoscopic techniques. These include wireless capsule endoscopy, balloon enteroscopy, chromoendoscopy, high-magnification endoscopy, and MRI. The increasing number of available modalities requires appreciation of their indications, strengths, and limitations. This article discusses these issues relevant to the clinician.

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References and Recommended Reading

  1. Kappelman MD, Rifas-Shiman SL, Kleinman K, et al.: The prevalence and geographic distribution of Crohn’s disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol 2007, 5:1424–1429.

    Article  PubMed  Google Scholar 

  2. Herrinton LJ, Liu L, Lafata JE, et al.: Estimation of the period prevalence of inflammatory bowel disease among nine health plans using computerized diagnoses and outpatient pharmacy dispensings. Inflamm Bowel Dis 2007, 13:451–461.

    Article  PubMed  Google Scholar 

  3. Loftus CG, Loftus EV Jr, Harmsen WS, et al.: Update on the incidence and prevalence of Crohn’s disease and ulcerative colitis in Olmsted County, Minnesota, 1940–2000. Inflamm Bowel Dis 2007, 13:254–261.

    Article  PubMed  Google Scholar 

  4. Bernstein CN, Wajda A, Svenson LW, et al.: The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol 2006, 101:1559–1568.

    Article  PubMed  Google Scholar 

  5. Gunesh S, Thomas GA, Williams GT, et al.: The incidence of Crohn’s disease in Cardiff over the last 75 years: an update for 1996–2005. Aliment Pharmacol Ther 2008, 27:211–219.

    Article  PubMed  CAS  Google Scholar 

  6. Gearry RB, Richardson A, Frampton CM, et al.: High incidence of Crohn’s disease in Canterbury, New Zealand: results of an epidemiologic study. Inflamm Bowel Dis 2006, 12:936–943.

    Article  PubMed  Google Scholar 

  7. Sood A, Midha V, Sood N, et al.: Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut 2003, 52:1587–1590.

    Article  PubMed  CAS  Google Scholar 

  8. Yang SK, Yun S, Kim JH, et al.: Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986–2005: a KASID study. Inflamm Bowel Dis 2008, 14:542–549.

    Article  PubMed  Google Scholar 

  9. Edwards CN, Griffith SG, Hennis AJ, Hambleton IR: Inflammatory bowel disease: incidence, prevalence, and disease characteristics in Barbados, West Indies. Inflamm Bowel Dis 2008, 14:1419–1424.

    Article  PubMed  CAS  Google Scholar 

  10. Abdul-Baki H, ElHajj I, El-Zahabi LM, et al.: Clinical epidemiology of inflammatory bowel disease in Lebanon. Inflamm Bowel Dis 2007, 13:475–480.

    Article  PubMed  Google Scholar 

  11. Nerich V, Monnet E, Etienne A, et al.: Geographical variations of inflammatory bowel disease in France: a study based on national health insurance data. Inflamm Bowel Dis 2006, 12:218–226.

    Article  PubMed  Google Scholar 

  12. Tsironi E, Feakins RM, Probert CS, et al.: Incidence of inflammatory bowel disease is rising and abdominal tuberculosis is falling in Bangladeshis in East London, United Kingdom. Am J Gastroenterol 2004, 99:1749–1755.

    Article  PubMed  Google Scholar 

  13. Pinsk V, Lemberg DA, Grewal K, et al.: Inflammatory bowel disease in the South Asian pediatric population of British Columbia. Am J Gastroenterol 2007, 102:1077–1083.

    Article  PubMed  Google Scholar 

  14. Carr I, Mayberry JF: The effects of migration on ulcerative colitis: a three-year prospective study among Europeans and first-and second-generation South Asians in Leicester (1991–1994). Am J Gastroenterol 1999, 94:2918–2922.

    PubMed  CAS  Google Scholar 

  15. Bernstein CN, Rawsthorne P, Blanchard JF: Population-based case-control study of measles, mumps, and rubella and inflammatory bowel disease. Inflamm Bowel Dis 2007, 13:759–762.

    Article  PubMed  Google Scholar 

  16. Kaplan GG, Pedersen BV, Andersson RE, et al.: The risk of developing Crohn’s disease after an appendectomy: a population-based cohort study in Sweden and Denmark. Gut 2007, 56:1387–1392.

    Article  PubMed  Google Scholar 

  17. Hallas J, Gaist D, Sorensen HT: Does appendectomy reduce the risk of ulcerative colitis? Inflamm Bowel Dis 2004, 15:173–178.

    Google Scholar 

  18. Lakatos PL, Szamosi T, Lakatos L: Smoking in inflammatory bowel diseases: good, bad or ugly? World J Gastroenterol 2007, 13:6134–6139.

    Article  PubMed  Google Scholar 

  19. Garcia Rodriguez LA, Ruigomez A, Panes J: Acute gastroenteritis is followed by an increased risk of inflammatory bowel disease. Gastroenterology 2006, 130:1588–1594.

    Article  PubMed  Google Scholar 

  20. Halfvarson J, Jess T, Magnuson A, et al.: Environmental factors in inflammatory bowel disease: a co-twin control study of a Swedish-Danish twin population. Inflamm Bowel Dis 2006, 12:925–933.

    Article  PubMed  Google Scholar 

  21. Wehkamp J, Salzman NH, Porter E, et al.: Reduced Paneth cell alpha-defensins in ileal Crohn’s disease. Proc Natl Acad Sci U S A 2005, 102:18129–18134.

    Article  PubMed  CAS  Google Scholar 

  22. Hugot JP: CARD15/NOD2 mutations in Crohn’s disease. Ann N Y Acad Sci 2006, 1072:9–18.

    Article  PubMed  CAS  Google Scholar 

  23. Tremaine WJ: Inflammatory bowel disease and Clostridium difficile-associated diarrhea: a growing problem. Clin Gastroenterol Hepatol 2007, 5:310–311.

    Article  PubMed  Google Scholar 

  24. McDonald LC, Killgore GE, Thompson A, et al.: An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med 2005, 353:2433–2441.

    Article  PubMed  CAS  Google Scholar 

  25. Issa M, Vijayapal A, Graham MB, et al.: Impact of Clostridium difficile on inflammatory bowel disease. Clin Gastroenterol Hepatol 2007, 5:345–351.

    Article  PubMed  Google Scholar 

  26. Jones PH, Farver TB, Beaman B, et al.: Crohn’s disease in people exposed to clinical cases of bovine paratuberculosis. Epidemiol Infect 2006, 134:49–56.

    Article  PubMed  CAS  Google Scholar 

  27. Feller M, Huwiler K, Stephan R, et al.: Mycobacterium avium subspecies paratuberculosis and Crohn’s disease: a systematic review and meta-analysis. Lancet Infect Dis 2007, 7:607–613.

    Article  PubMed  Google Scholar 

  28. Abubakar I, Myhill D, Aliyu SH, Hunter PR: Detection of Mycobacterium avium subspecies paratuberculosis from patients with Crohn’s disease using nucleic acid-based techniques: a systematic review and meta-analysis. Inflamm Bowel Dis 2008, 14:401–410.

    Article  PubMed  CAS  Google Scholar 

  29. Cousins DV, Whittington R, Marsh I, et al.: Mycobacteria distinct from Mycobacterium avium subsp. paratuberculosis isolated from the faeces of ruminants possess IS 900-like sequences detectable IS 900 polymerase chain reaction: implications for diagnosis. Mol Cell Probes 1999, 13:431–442.

    Article  PubMed  CAS  Google Scholar 

  30. Braun-Fahrlander C, Riedler J, Herz U, et al.: Environmental exposure to endotoxin and its relation to asthma in schoolage children. N Engl J Med 2002, 347:869–877.

    Article  PubMed  Google Scholar 

  31. Weinstock JV, Summers RW, Elliott DE, et al.: The possible link between de-worming and the emergence of immunological disease. J Lab Clin Med 2002, 139:334–338.

    Article  PubMed  Google Scholar 

  32. Amre DK, Lambrette P, Law L, et al.: Investigating the hygiene hypothesis as a risk factor in pediatric onset Crohn’s disease: a case-control study. Am J Gastroenterol 2006, 101:1005–1011.

    Article  PubMed  Google Scholar 

  33. Bernstein CN, Rawsthorne P, Cheang M, et al.: A populationbased case control study of potential risk factors for IBD. Am J Gastroenterol 2006, 101:993–1002.

    Article  PubMed  Google Scholar 

  34. Lashner BA, Loftus EV Jr: True or false? The hygiene hypothesis for Crohn’s disease. Am J Gastroenterol 2006, 101:1003–1004.

    Article  PubMed  Google Scholar 

  35. Radon K, Windstetter D, Poluda AL, et al.: Contact with farm animals in early life and juvenile inflammatory bowel disease: a case-control study. Pediatrics 2007, 120:354–361.

    Article  PubMed  Google Scholar 

  36. Peyrin-Biroulet L, Standaert-Vitse A, Branche J, Chamaillard M: IBD serological panels: facts and perspectives. Inflamm Bowel Dis 2007, 13:1561–1566.

    Article  PubMed  Google Scholar 

  37. Ashorn S, Raukola H, Valineva T, et al.: Elevated serum anti-Saccharomyces cerevisiae, anti-I2 and anti-OmpW antibody levels in patients with suspicion of celiac disease. J Clin Immunol 2008, 28:486–494.

    Article  PubMed  CAS  Google Scholar 

  38. Toumi D, Mankai A, Belhadj R, et al.: Anti-Saccharomyces cerevisiae antibodies in coeliac disease. Scand J Gastroenterol 2007, 42:821–826.

    Article  PubMed  CAS  Google Scholar 

  39. Makharia GK, Sachdev V, Gupta R, et al.: Anti-Saccharomyces cerevisiae antibody does not differentiate between Crohn’s disease and intestinal tuberculosis. Dig Dis Sci 2007, 52:33–39.

    Article  PubMed  Google Scholar 

  40. Mallant-Hent R, Mary B, von Blomberg E, et al.: Disappearance of anti-Saccharomyces cerevisiae antibodies in coeliac disease during a gluten-free diet. Eur J Gastroenterol Hepatol 2006, 18:75–78.

    Article  PubMed  CAS  Google Scholar 

  41. Reese GE, Constantinides VA, Simillis C, et al.: Diagnostic precision of anti-Saccharomyces cerevisiae antibodies and perinuclear antineutrophil cytoplasmic antibodies in inflammatory bowel disease. Am J Gastroenterol 2006, 101:2410–2422.

    Article  PubMed  CAS  Google Scholar 

  42. Dotan I, Fishman S, Dgani Y, et al.: Antibodies against laminaribioside and chitobioside are novel serologic markers in Crohn’s disease. Gastroenterology 2006, 131:366–378.

    Article  PubMed  CAS  Google Scholar 

  43. Fleshner P, Ippoliti A, Dubinsky M, et al.: Both preoperative perinuclear antineutrophil cytoplasmic antibody and anti-CBir1 expression in ulcerative colitis patients influence pouchitis development after ileal pouch-anal anastomosis. Clin Gastroenterol Hepatol 2008, 6:561–568.

    Article  PubMed  Google Scholar 

  44. Dendrinos KG, Becker JM, Stucchi AF, et al.: Anti-Saccharomyces cerevisiae antibodies are associated with the development of postoperative fistulas following ileal pouchanal anastomosis. J Gastrointest Surg 2006, 10:1060–1064.

    Article  PubMed  Google Scholar 

  45. Schoepfer AM, Trummler M, Seeholzer P, et al.: Discriminating IBD from IBS: comparison of the test performance of fecal markers, blood leukocytes, CRP, and IBD antibodies. Inflamm Bowel Dis 2008, 14:32–39.

    Article  PubMed  Google Scholar 

  46. Langhorst J, Elsenbruch S, Koelzer J, et al.: Noninvasive markers in the assessment of intestinal inflammation in inflammatory bowel diseases: performance of fecal lactoferrin, calprotectin, and PMN-elastase, CRP, and clinical indices. Am J Gastroenterol 2008, 103:162–169.

    PubMed  Google Scholar 

  47. Sipponen T, Savilahti E, Kolho KL, et al.: Crohn’s disease activity assessed by fecal calprotectin and lactoferrin: correlation with Crohn’s Disease Activity Index and endoscopic findings. Inflamm Bowel Dis 2008, 14:40–46.

    Article  PubMed  Google Scholar 

  48. Triester SL, Leighton JA, Leontiadis GI, et al.: A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease. Am J Gastroenterol 2006, 101:954–964.

    Article  PubMed  Google Scholar 

  49. Biancone L, Calabrese E, Petruzziello C, et al.: Wireless capsule endoscopy and small intestine contrast ultrasonography in recurrence of Crohn’s disease. Inflamm Bowel Dis 2007, 13:1256–1265.

    Article  PubMed  Google Scholar 

  50. Lashner BA: Sensitivity-specificity trade-off for capsule endoscopy in IBD: is it worth it? Am J Gastroenterol 2006, 101:965–966.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. 4614 JCP, Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Cyrus P. Tamboli

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  1. Sobia Ali
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Correspondence to Cyrus P. Tamboli.

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Ali, S., Tamboli, C.P. Advances in epidemiology and diagnosis of inflammatory bowel diseases. Curr Gastroenterol Rep 10, 576–584 (2008). https://doi.org/10.1007/s11894-008-0105-9

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