Skip to main content
SpringerLink
Log in

Characteristics and Trends in the Incidence of Inflammatory Bowel Disease in Korean Children: A Single-Center Experience

  • Original Article
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Background

Inflammatory bowel disease (IBD) is rare in Asian children and few reports on pediatric IBD have appeared.

Aims

We, therefore, investigated the incidence trends and clinical characteristics of pediatric IBD in Korea.

Methods

We enrolled 48 children with Crohn’s disease (CD) and 14 children with ulcerative colitis (UC) from 1996 to 2007. Trends in annual enrollment and clinical characteristics were retrospectively evaluated by medical record review.

Results

During the 12 years of observation, the number of new enrollments gradually increased. CD showed male predominance (33 boys, 15 girls), but more females presented with UC (4 boys, 10 girls). A relevant family history was observed in 3 (4.9%) of the 61 unrelated families. The most common presenting symptom was abdominal pain (67%) in CD and hematochezia (93%) in UC. Growth delay was observed in 10% of CD patients, but not in any of the UC patients. In CD, colonic involvement occurred in 87% of patients, ileal involvement in 87%, and both the small bowel and colon were affected in 75%. With UC, pancolitis occurred in 43% of patients, left-sided colitis in 36%, and proctitis in 21%, including all three patients with appendiceal orifice inflammation. The most frequent disease behavior was inflammatory in 85% of patients, but perianal fistula was noted in 50% of CD patients.

Conclusion

This study showed that the incidence of pediatric IBD has been rapidly increasing in Korea in recent years. Relevant family history is less prevalent and phenotypic expression differs from what is seen in Western countries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Whelan G. Epidemiology of inflammatory bowel disease. Med Clin North Am. 1990;74:1–12.

    PubMed  CAS  Google Scholar 

  2. Yang SK, Loftus EV Jr, Sandborn WJ. Epidemiology of inflammatory bowel disease in Asia. Inflamm Bowel Dis. 2001;7:260–270.

    Article  PubMed  CAS  Google Scholar 

  3. Mamula P, Markowitz JE, Baldassano RN. Inflammatory bowel disease in early childhood and adolescence: special considerations. Gastroenterol Clin North Am. 2003;32:967–995. viii.

    Article  PubMed  Google Scholar 

  4. Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child. 2003;88:995–1000.

    Article  PubMed  CAS  Google Scholar 

  5. Kugathasan S, Judd RH, Hoffmann RG, et al. Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: a statewide population-based study. J Pediatr. 2003;143:525–531.

    Article  PubMed  Google Scholar 

  6. Armitage E, Drummond HE, Wilson DC, et al. Increasing incidence of both juvenile-onset Crohn’s disease and ulcerative colitis in Scotland. Eur J Gastroenterol Hepatol. 2001;13:1439–1447.

    Article  PubMed  CAS  Google Scholar 

  7. Askling J, Grahnquist L, Ekbom A, et al. Incidence of paediatric Crohn’s disease in Stockholm, Sweden. Lancet. 1999;354:1179.

    Article  PubMed  CAS  Google Scholar 

  8. Barton JR, Gillon S, Ferguson A. Incidence of inflammatory bowel disease in Scottish children between 1968 and 1983; marginal fall in ulcerative colitis, three-fold rise in Crohn’s disease. Gut. 1989;30:618–622.

    Article  PubMed  CAS  Google Scholar 

  9. Sawczenko A, Sandhu BK, Logan RFA, et al. Prospective survey of childhood inflammatory bowel disease in the British Isles. Lancet. 2001;357:1093–1094.

    Article  PubMed  CAS  Google Scholar 

  10. Seo JK, Yeon KM, Chi JG. Inflammatory bowel disease in children—clinical, endoscopic, radiologic and histopathologic investigation. J Korean Med Sci. 1992;7:221–235.

    PubMed  CAS  Google Scholar 

  11. Treepongkaruna S, Pienvichit P, Sornmayura P, et al. Inflammatory bowel disease in Thai children: presentations and outcomes of treatment. Asian Pac J Allergy Immunol. 2006;24:73–79.

    PubMed  Google Scholar 

  12. Tsai CH, Chen HL, Ni YH, et al. Characteristics and trends in incidence of inflammatory bowel disease in Taiwanese children. J Formos Med Assoc. 2004;103:685–691.

    PubMed  Google Scholar 

  13. Yang SK, Hong WS, Min YI, et al. Incidence and prevalence of ulcerative colitis in the Songpa-Kangdong district, Seoul, Korea, 1986–1997. J Gastroenterol Hepatol. 2000;15:1037–1042.

    Article  PubMed  CAS  Google Scholar 

  14. Yang SK, Yun S, Kim JH, et al. Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986–2005: a KASID study. Inflamm Bowel Dis. 2008;14:542–549.

    Article  PubMed  Google Scholar 

  15. IBD Working Group of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Inflammatory bowel disease in children and adolescents: recommendations for diagnosis—the Porto criteria. J Pediatr Gastroenterol Nutr. 2005;41:1–7.

    Article  Google Scholar 

  16. Bousvaros A, Antonioli DA, Colletti RB, et al. Differentiating ulcerative colitis from Crohn disease in children and young adults: report of a Working Group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn’s and Colitis Foundation of America. J Pediatr Gastroenterol Nutr. 2007;44:653–674.

    Article  PubMed  Google Scholar 

  17. Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55:749–753.

    Article  PubMed  CAS  Google Scholar 

  18. Gasche C, Scholmerich J, Brynskov J, et al. A simple classification of Crohn’s disease: report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998. Inflamm Bowel Dis. 2000;6:8–15.

    PubMed  CAS  Google Scholar 

  19. Korea Center for Disease Control and Prevention, The Korean Pediatric Society, The Committee for the Development of Growth Standard for Korean Children and Adolescents. 2007 Korean Children and Adolescents Growth Standard (commentary for the development of 2007 growth chart). [Government report online]. Seoul: Division of Chronic Disease Surveillance. Available online at: http://www.cdc.go.kr/webcdc/.

  20. Lee NY, Park JH. Clinical features and course of Crohn disease in children. Korean J Gastrointest Endosc. 2007;34:193–199.

    Google Scholar 

  21. Spray C, Debelle GD, Murphy MS. Current diagnosis, management and morbidity in paediatric inflammatory bowel disease. Acta Paediatr. 2001;90:400–405.

    Article  PubMed  CAS  Google Scholar 

  22. Pinsk V, Lemberg DA, Grewal K, et al. Inflammatory bowel disease in the South Asian pediatric population of British Columbia. Am J Gastroenterol. 2007;102:1077–1083.

    Article  PubMed  Google Scholar 

  23. Yao T, Matsui T, Hiwatashi N. Crohn’s disease in Japan: diagnostic criteria and epidemiology. Dis Colon Rectum. 2000;43:S85–S93.

    Article  PubMed  CAS  Google Scholar 

  24. Leong RW, Lau JY, Sung JJ. The epidemiology and phenotype of Crohn’s disease in the Chinese population. Inflamm Bowel Dis. 2004;10:646–651.

    Article  PubMed  Google Scholar 

  25. Bernstein CN, Wajda A, Svenson LW, et al. The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol. 2006;101:1559–1568.

    Article  PubMed  Google Scholar 

  26. Jacobsen BA, Fallingborg J, Rasmussen HH, et al. Increase in incidence and prevalence of inflammatory bowel disease in Northern Denmark: a population-based study, 1978–2002. Eur J Gastroenterol Hepatol. 2006;18:601–606.

    Article  PubMed  Google Scholar 

  27. Park JB, Yang SK, Byeon JS, et al. Familial occurrence of inflammatory bowel disease in Korea. Inflamm Bowel Dis. 2006;12:1146–1151.

    Article  PubMed  Google Scholar 

  28. Yoshida Y, Murata Y. Inflammatory bowel disease in Japan: studies of epidemiology and etiopathogenesis. Med Clin North Am. 1990;74:67–90.

    PubMed  CAS  Google Scholar 

  29. Weinstein TA, Levine M, Pettei MJ, et al. Age and family history at presentation of pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2003;37:609–613.

    Article  PubMed  Google Scholar 

  30. Gryboski JD. Crohn’s disease in children 10 years old and younger: comparison with ulcerative colitis. J Pediatr Gastroenterol Nutr. 1994;18:174–182.

    Article  PubMed  CAS  Google Scholar 

  31. Barton JR, Ferguson A. Clinical features, morbidity and mortality of Scottish children with inflammatory bowel disease. Q J Med. 1990;75:423–439.

    PubMed  CAS  Google Scholar 

  32. Heyman MB, Kirschner BS, Gold BD, et al. Children with early-onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr. 2005;146:35–40.

    Article  PubMed  Google Scholar 

  33. Michener WM, Farmer RG, Mortimer EA. Long-term prognosis of ulcerative colitis with onset in childhood or adolescence. J Clin Gastroenterol. 1979;1:301–305.

    Article  PubMed  CAS  Google Scholar 

  34. Rubin GP, Hungin AP, Kelly PJ, et al. Inflammatory bowel disease: epidemiology and management in an English general practice population. Aliment Pharmacol Ther. 2000;14:1553–1559.

    Article  PubMed  CAS  Google Scholar 

  35. Farmer RG, Easley KA, Rankin GB. Clinical patterns, natural history, and progression of ulcerative colitis. A long-term follow-up of 1116 patients. Dig Dis Sci. 1993;38:1137–1146.

    Article  PubMed  CAS  Google Scholar 

  36. Yang SK, Jung HY, Kang GH, et al. Appendiceal orifice inflammation as a skip lesion in ulcerative colitis: an analysis in relation to medical therapy and disease extent. Gastrointest Endosc. 1999;49:743–747.

    Article  PubMed  CAS  Google Scholar 

  37. Byeon JS, Yang SK, Myung SJ, et al. Clinical course of distal ulcerative colitis in relation to appendiceal orifice inflammation status. Inflamm Bowel Dis. 2005;11:366–371.

    Article  PubMed  Google Scholar 

  38. Palder SB, Shandling B, Bilik R, et al. Perianal complications of pediatric Crohn’s disease. J Pediatr Surg. 1991;26:513–515.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

This study was supported by a grant (2008-173) from Asan Institute of Life Science.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, 388-1 Pungnap-Dong, Songpa-Gu, Seoul, 138-736, Korea

    Bong Jin Kim, Seung Min Song, Kyung Mo Kim, Yeoun Joo Lee, Kang Won Rhee, Joo Young Jang & Seong Jong Park

  2. Department of Pediatric Radiology, Asan Medical Center Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea

    Chong Hyun Yoon

  3. Department of Pediatrics, Fatima Obstetrics & Gynecology Clinic, Gwangmyeong, Korea

    Bong Jin Kim

  4. Department of Pediatrics, Ajou University School of Medicine, Yeongtong-Gu, Suwon, Korea

    Joo Young Jang

Authors
  1. Bong Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Seung Min Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kyung Mo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yeoun Joo Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kang Won Rhee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Joo Young Jang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Seong Jong Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chong Hyun Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kyung Mo Kim.

Additional information

Bong Jin Kim and Seung Min Song contributed equally to this article.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, B.J., Song, S.M., Kim, K.M. et al. Characteristics and Trends in the Incidence of Inflammatory Bowel Disease in Korean Children: A Single-Center Experience. Dig Dis Sci 55, 1989–1995 (2010). https://doi.org/10.1007/s10620-009-0963-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-009-0963-5

Keywords

Search

Navigation