Incidence, clinical characteristics, and natural history of pediatric IBD in Wisconsin: A population-based epidemiological study

Tonya Adamiak, Dorota Walkiewicz-Jedrzejczak, Daryl Fish, Christopher Brown, Jeanne Tung, Khalid Khan, William Faubion, Roger Park, Janice Heikenen, Michael Yaffee, Maria T. Rivera-Bennett, Marcy Wiedkamp, Michael Stephens, Richard Noel, Melodee Nugent, Justin Nebel, Pippa Simpson, Michael D. Kappelman, Subra Kugathasan

Research output: Contribution to journalArticle

64 Scopus citations

Abstract

Background: Epidemiological studies of pediatric inflammatory bowel diseases (IBD) are needed to generate etiological hypotheses and inform public policy; yet, rigorous population-based studies of the incidence and natural history of Crohn's disease (CD) and ulcerative colitis (UC) in the United States are limited. Methods: We developed a field-tested prospective system for identifying all new cases of IBD among Wisconsin children over an 8-year period (2000-2007). Subsequently, at the end of the study period, we retrospectively reconfirmed each case and characterized the clinical course of this incident cohort. Results: The annual incidence of IBD among Wisconsin children was 9.5 per 100,000 (6.6 per 100,000 for CD and 2.4 per 100,000 for UC). Approximately 19% of incident cases occurred in the first decade of life. Over the 8-year study period, the incidence of both CD and UC remained relatively stable. Additionally, (1) childhood IBD affected all racial groups equally, (2) over a follow-up of 4 years, 17% of patients with CD and 13% of patients with patients with UC required surgery, and (3) 85% and 40% of children with CD were treated with immunosuppressives and biologics, respectively, compared with 62% and 30% of patients with UC. Conclusions: As in other North American populations, these data confirm a high incidence of pediatric-onset IBD. Importantly, in this Midwestern U. S. population, the incidence of CD and UC seems to be relatively stable over the last decade. The proportions of children requiring surgery and undergoing treatment with immunosuppressive and biological medications underscore the burden of these conditions.

Original languageEnglish (US)
Pages (from-to)1218-1223
Number of pages6
JournalInflammatory bowel diseases
Volume19
Issue number6
DOIs
StatePublished - May 1 2013

Keywords

  • Children
  • Crohn's disease
  • Epidemiology
  • IBD
  • Ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

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    Adamiak, T., Walkiewicz-Jedrzejczak, D., Fish, D., Brown, C., Tung, J., Khan, K., Faubion, W., Park, R., Heikenen, J., Yaffee, M., Rivera-Bennett, M. T., Wiedkamp, M., Stephens, M., Noel, R., Nugent, M., Nebel, J., Simpson, P., Kappelman, M. D., & Kugathasan, S. (2013). Incidence, clinical characteristics, and natural history of pediatric IBD in Wisconsin: A population-based epidemiological study. Inflammatory bowel diseases, 19(6), 1218-1223. https://doi.org/10.1097/MIB.0b013e318280b13e