The symptoms of Crohn's disease and ulcerative colitis, the two main forms of inflammatory bowel disease (IBD), can be severe and lifelong. And the condition is becoming increasingly common worldwide.
The battle within
In general, IBD is thought to occur when the immune system overreacts to the bacterial community that normally dwells in the gut, setting in motion a chain of inflammation events that can damage and destroy the intestinal wall.
Similar, yet different
Most cases of IBD are classified as either ulcerative colitis (UC) or Crohn’s disease (CD). The relative prevalence of these two conditions varies widely across different geographical regions (see chart).
Between 5% and 15% of cases cannot immediately be put into either category and are instead referred to as ‘indeterminate colitis’. Despite sharing similar symptoms, there are important pathological distinctions between the two main forms of IBD.
Nature and nurture
A variety of hereditary, environmental and lifestyle factors are thought to influence IBD pathology. However, researchers are still grappling with exactly how these elements individually and collectively affect the natural history of the disease.
A growing global disease
IBD is most common in North America, Western and Northern Europe, Australia and New Zealand4. Cases are much less common in non-Western nations, but this is changing — incidence rates have climbed rapidly in recent years in parts of Asia and South America.
Regional, local, individual
Beneath the global data lie smaller-scale trends that reveal the complex mix of factors that determine a person’s risk of disease.
Sources
-
1. Molodecky, N. A. et al. Gastroenterology 142, 46–54 (2012).
-
2. Ananthakrishnan, A. N. Nature Rev. Gastroenterol. Hepatol. 12, 205–217 (2015).
-
3. Sartor, R. B. et al. Nature Clin. Prac. Gastroenterol. Hepatol. 3, 390–407 (2006).
-
4. Kaplan, G. G. Nature Rev. Gastroenterol. Hepatol. 12, 720–727 (2015).
-
5. Thia, K. T. et al. Am. J. Gastroenterol. 103, 3167–3182 (2008).
-
6. Victoria, C. R. et al. Arq. Gastroenterol. 46, 20–25 (2009).
-
7. Khalili, H. Gut 61, 1686–1692 (2012).
-
8. Soon, I. S. et al. BMC Gastroenterol. 12, 51 (2012).
-
9. Bernstein, C. N. et al. Am. J. Gastroenterol. 101, 993–1002 (2006).
Related links
Related links
Related links in Nature Research
Epidemiology: Rising in the East
Rights and permissions
About this article
Cite this article
Eisenstein, M. Biology: A slow-motion epidemic. Nature 540, S98–S99 (2016). https://doi.org/10.1038/540S98a
Published:
Issue Date:
DOI: https://doi.org/10.1038/540S98a
This article is cited by
-
Perinatal tissue-derived exosomes ameliorate colitis in mice by regulating the Foxp3 + Treg cells and gut microbiota
Stem Cell Research & Therapy (2023)
-
RhoB affects colitis through modulating cell signaling and intestinal microbiome
Microbiome (2022)
-
Treatment of murine colitis by Saccharomyces boulardii secreting atrial natriuretic peptide
Journal of Molecular Medicine (2020)
-
Physical and functional interaction between A20 and ATG16L1-WD40 domain in the control of intestinal homeostasis
Nature Communications (2019)