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According to a new report, the prevalence of inflammatory bowel disease (IBD) among Canadians is increasing at an "alarming" rate, especially among children and the elderly.
Crohn's and Colitis Canada released Thursday the results of a multi-year report on the impact of Crohn's disease and ulcerative colitis – the two major forms of IBD – in Canada.
IBD is a group of disorders that cause severe inflammation of parts of the gastrointestinal tract and the development of ulcers. Symptoms of these permanent diseases can be debilitating and can include severe abdominal pain, internal bleeding, fatigue, vomiting and frequent visits to the bathroom.
According to the organization, 270,000 Canadians currently live with the disease – 135,000 with Crohn's disease, 120,000 with ulcerative colitis and 15,000 with unclbadified IBD.
By 2030, this number is expected to increase by 50% and approximately 400,000 Canadians, or 1% of the population, will be diagnosed with IBD.
"By 2018, the cost of care for people with IBD was about $ 2.5 billion and, as more and more people are living with these diseases, these costs will increase dramatically," said Mina Mawani, President and CEO of Crohn's & Colitis Canada. CTVNews.ca Thursday. "We are giving warning and telling the government that it is about growing diseases and we need to start thinking about it now and confronting them."
Incidence in children
Although Crohn's disease and colitis can be diagnosed at any age, symptoms usually appear in adolescence or early adulthood, explained the report's co-chair and author, Dr. Eric Benchimol, pediatric gastroenterologist at the Children's Hospital of Eastern Ontario. .
However, the report found that the diagnosis of IBD was recently diagnosed in children faster than any other age group. In addition, young children under five were diagnosed with IBD faster than other children.
According to research, more than 7,000 children under 18 with IBD live in Canada. This is a dramatic increase of 50% over 15 years ago and highlights the changing nature of the disease.
The number of newly diagnosed children in this age group increased by 7.2% between 1999 and 2008, and this number is expected to increase.
Benchimol said he thought that a combination of factors was causing the increase in the number of diagnoses in children, including earlier detection and environmental factors.
He added that there were more pediatric gastroenterologists and better technology for diagnostic tests, such as colonoscopies, to recognize and diagnose IBD in children. However, he also believes that the environment can also play an important role in the development of IBD in young children.
"There are probably many environmental risk factors to which children are exposed at a very young age, which then alter their intestinal microbiome – the bacterial composition of their intestines – and then activate the genetic risk they may have had to later develop an ITN. He explained.
The statistics are troubling because children respond differently to treatments for ITNs and are at greater risk for side effects from medications, according to the report. Children also have a more serious illness and need to see their doctor more often, which means that the treatment can cost them more.
"If we now see younger and younger children with the disease, it means they're living longer with the disease and they're using more of the health care system, which means the costs will increase." for the Canadian health system. "Said Benchimol.
ITN and seniors
While children have been identified as having the highest rate of new diagnoses, people over the age of 65 have been identified as the fastest growing demographic group currently living with IBD.
According to Benchimol, the high prevalence of IBD among Canadian seniors is the result of new diagnoses badociated with patients with the disease for many years, but recently becoming seniors. According to the results, the higher the number of elderly people living with IBD, the greater the risk of complications badociated with other conditions.
"Risks badociated with IBD surgeries and complications of other age-related diseases and their medications further complicate treatment options and may lead to increased use of health care," says report.
While Canada's seniors population is growing rapidly, Mawani said the government needs to start planning for the growing social and economic impacts of ITNs.
"We need governments to start thinking about the number of gastroenterologists, the number of IBD nurses we will need in the future, and getting ready to train more as we experience a higher rate of IBD. these diseases, "she said.
Immigrant populations
In addition to children and the elderly, some immigrant groups also have high rates of IBD in Canada. The report indicated that new diagnoses among Ashkenazi Jews and South Asians were higher than in other ethnic groups.
"Ashkenazi Jews carry gene mutations common to all Crohn's patients, but also unique mutations that could increase their susceptibility," the report says.
According to research, immigrants from South Asia have a higher risk of contracting IBD, especially when they arrive in Canada at a young age, than other immigrants, such as those from Canada. East Asia.
"What we are seeing are children born to immigrants born in Canada. They actually have the same rate or more than the children of Canadian-born Canadians. Therefore, being born or being exposed early to a Canadian environment seems to increase the risk they were low risk in their home country, "said Benchimol.
recommendations
In addition to these statistics, Crohn's and Colitis Canada have issued a number of recommendations calling on governments to recognize the IBD as a national health priority and to increase the resources allocated to its treatment and prevention.
According to Benchimol, other recommendations include faster translation of academic research at the bedside to improve patient care; increased research and funding in specific groups, such as seniors, children, immigrants and pregnant women with IBD; and a public health and education campaign to raise awareness and reduce the stigma attached to these diseases.
Mawani also added that increased access to gastroenterologists and specialized care, especially for patients living in rural areas, is also needed to improve care.
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