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Inflammatory Bowel Disease: Overview

Inflammatory Bowel Disease: Overview. IBD: Overview. Prevalence: ~250 cases per 100,000 1 More than 1 million cases estimated in United States 1 Ulcerative colitis (UC): 50% 1 Crohn’s disease (CD): 50% 1 Incidence:  15 cases per 100,000 1 Onset: 30% between 10 and 19 years of age 2

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Inflammatory Bowel Disease: Overview

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  1. Inflammatory Bowel Disease:Overview

  2. IBD: Overview • Prevalence: ~250 cases per 100,0001 • More than 1 million cases estimated in United States1 • Ulcerative colitis (UC): 50%1 • Crohn’s disease (CD): 50%1 • Incidence: 15 cases per 100,0001 • Onset: 30% between 10 and 19 years of age2 • Young children: <2%2 • Peak age of onset: 20s & 30s, again in 60s3 • Slightly greater risk for women and elderly4 1CCFA Library: Basic Facts. Available at: http://www.ccfa.org. 2Grand RJ, et al. Clin Invest Med. 1996;19:373-380. 3Hanauer SB. Cecil Textbook of Medicine. 20th ed. Philadelphia, Pa: WB Saunders Co; 1996:707. 4Lashner BA. In: Stein SH, Rood RP, eds. Inflammatory Bowel Disease: A Guide for Patients and Their Families. 2nd ed. Philadelphia, Pa: Lippincott-Raven Publishers; 1999:23-29.

  3. IBD: Overview (cont’d) • Scope of disorder (United States) • 700,000 physician visits per year • 100,000 hospitalizations per year • CD accounts for two thirds • Long-term outlook • Chronic, lifelong disease • Acute flare-ups alternating with remission • Complications and increased mortality • Surgery for 50% to 80% of CD patients Calkins BM. Digestive Diseases in the United States: Epidemiology and Impact. Bethesda, Md: National Institutes of Health; 1994.

  4. Risk for Developing CD 60 50.0 50 40 37.0 Empiric Risk for Developing Crohn's Disease (%) 30 20 16.8 10 7.5 7.4 7.0 4.6 <4.0 <0.2 0.1 0 Offspr BothParents Sib AshkJew HeterozygoteNOD2 OffsprAshk Jew SibNon-Jew MZ Twin Parent DZ Twin HomozygoteNOD2 GeneralPopulation

  5. IBD: Systemic Complications Growth failurein children Eyeinflammation* Lowerbone density* Kidneystones Liver andbile ductinflammation Subfertility* Ovaries Uterus Gallstones Arthritis and joint pains Skin lesions *Higher incidence in women.

  6. Influence of Gender on Illness-Related Concerns in IBD • Study of 343 men and women • Women report higher levels of symptom severity (P=.04) • Higher levels of rating of IBD patient concerns (P<.001) Maunder R, et al. Can J Gastroenterol. 1999;13:728-732.

  7. Greater in Women Than in Men Feelings about body Attractiveness Feeling alone Having children Intimacy (CD) Sexual performance (CD) Independent of Gender Energy level Medication effects Uncertain nature of IBD Having surgery Having ostomy bag Reaching full potential Being a burden Patients’ Concerns in IBD Maunder R, et al. Can J Gastroenterol. 1999;13:728-732.

  8. Gender-Related Considerations in IBD

  9. The Effect of Smoking on Crohn’s Disease in Women • There are now two studies that have specifically addressed the gender effect of tobacco • Women smokers undergoing surgery are 5 times more likely to have a recurrence than a non-smoker, and recur more quickly1 • Women smokers hastened onset of disease and increased the need for immunomodulators2 1Kane SV, Gastroenterol 2002; 124(5):A1169 2 Cosnes J Clin Gastro and Hepatol 2004;2:41-48.

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