Inflammatory bowel disease in Asia: A systematic review

Authors

  • Lani Prideaux,

    1. Department of Gastroenterology St Vincent's Hospital Melbourne and University of Melbourne, Fitzroy, Victoria, Australia
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  • Michael A Kamm,

    1. Department of Gastroenterology St Vincent's Hospital Melbourne and University of Melbourne, Fitzroy, Victoria, Australia
    2. Imperial College, London, UK
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  • Peter P De Cruz,

    1. Department of Gastroenterology St Vincent's Hospital Melbourne and University of Melbourne, Fitzroy, Victoria, Australia
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  • Francis K L Chan,

    1. Institute of Digestive Disease, Chinese University Hong Kong, Hong Kong
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  • Siew C Ng

    Corresponding author
    1. Department of Gastroenterology St Vincent's Hospital Melbourne and University of Melbourne, Fitzroy, Victoria, Australia
    2. Institute of Digestive Disease, Chinese University Hong Kong, Hong Kong
      Professor Siew C Ng, Institute of Digestive Disease, Department of Medicine and Therapeutics, Chinese University Hong Kong, Hong Kong 1, China. Email: siewchienng@cuhk.edu.hk
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Professor Siew C Ng, Institute of Digestive Disease, Department of Medicine and Therapeutics, Chinese University Hong Kong, Hong Kong 1, China. Email: siewchienng@cuhk.edu.hk

Abstract

The incidence and prevalence of inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), are lower in Asia than in the West. However, across Asia the incidence and prevalence of IBD has increased rapidly over the last two to four decades. These changes may relate to increased contact with the West, westernization of diet, increasing antibiotics use, improved hygiene, vaccinations, or changes in the gut microbiota. Genetic factors also differ between Asians and the Caucasians. In Asia, UC is more prevalent than CD, although CD incidence is rapidly increasing in certain areas. There is a male predominance of CD in Asia, but a trend towards equal sex distribution for UC. IBD is diagnosed at a slightly older age than in the West, and there is rarely a second incidence peak as in the West. A positive family history is much less common than in the West, as are extra-intestinal disease manifestations. There are clear ethnic differences in incidence within countries in Asia, and an increased incidence in IBD in migrants from Asia to the West. Research in Asia, an area of rapidly changing IBD epidemiology, may lead to the discovery of critical etiologic factors that lead to the development of IBD.

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