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Endoscopy
Original research
Incidence and prevalence of inflammatory bowel disease in Devon, UK
  1. Ben Hamilton1,
  2. Harry Green2,
  3. Neel Heerasing1,
  4. Peter Hendy1,
  5. Lucy Moore1,
  6. Neil Chachlani1,
  7. Claire Bewshea1,
  8. Nicholas A Kennedy1,
  9. Tariq Ahmad3,
  10. James Goodhand1,
  11. Gareth Walker1
  1. 1Exeter IBD Research Group, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  2. 2Exeter IBD Research Group, University of Exeter, Exeter, Devon, UK
  3. 3Medicine, University of Exeter, exeter, devon, UK
  1. Correspondence to Dr Ben Hamilton, Exeter IBD Research Group, Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, UK; benjamin.hamilton{at}nhs.net

Abstract

Background and aims We sought to define temporal changes in prevalence of inflammatory bowel disease (IBD) in East Devon, UK, in order to facilitate service planning over the next 5 years.

Methods Multiple primary and secondary care databases were used to identify and verify cases. Point prevalence and incidence of IBD were reported in April 2017 and from 2008 to 2016, respectively. Future prevalence and healthcare activity requirements were estimated by linear regression.

Results Prevalence of ulcerative colitis (UC), Crohn’s disease (CD) and inflammatory bowel disease unclassified (IBDU) were 479.72, 265.94 and 35.34 per 100 000 persons, respectively. In 2016, the incidence rates of UC, CD and IBDU were 15.4, 10.7 and 1.4 per 100 000 persons per year, respectively. There were no significant changes in the incidence of CD (p=0.49, R=0.26) or UC (p=0.80, R=0.10). IBD prevalence has increased by 39.9% (95% CI 28.2 to 53.7) in the last 10 years without differences in the rate of change between UC and CD. Overall, 27% of patients were managed in primary care, a quarter of whom were eligible but not receiving endoscopic surveillance. Outpatient clinics, MRI and biologic use, but not helpline calls, admissions, or surgeries increased over and above the change in IBD prevalence.

Conclusions We report one of the highest prevalence and incidence rates of IBD from Northern Europe. Overall, IBD incidence is static, but prevalence is increasing. We estimate that 1% of our population will live with IBD between 2025 and 2030.

  • inflammatory bowel disease
  • epidemiology
  • primary care

https://doi.org/10.1136/flgastro-2019-101369

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    Footnotes

    • BH and HG are joint first authors.

    • Twitter @DrNickKennedy

    • Contributors NH, PH, GW and TA participated in the conception, design and coordination of the study. NH, PH, LM and GW collected primary care data, and BH, NH and NAK collected secondary care data. NH and PH performed the case verification. Data analysis was performed by BH and HG. The manuscript was written by BH, HG, NH, NC, CB, TA and JG. All authors assisted in the review and approval of the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was classified as a service evaluation, in accordance with the guidelines of the UK Health Research Authority; formal ethical approval and individual patient consent were not mandated.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. Data contain patient identifiable information and under GDPR must be stored deidentified where possible on secure NHS servers, and is not publicly available. Limited datasets may be shared to other NHS users when clinical justification is warranted.

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