Inflammatory bowel disease: estimates from the global burden of disease 2017 study

Background: Inflammatory bowel disease (IBD) is a significant health problem in the industrialised world, currently increasing in developing countries. Understanding the global burden of IBD is important to tackle increasing disease occurrence. Aim: To investigate the GBD (Global Burden of Disease) 2017 Study Database summarising and critically evaluating the global burden of IBD. Methods: We presented age-standardised prevalence estimates, disability-adjusted life years (DALYs) and its components: years lived with disability (YLDs) and years of life lost (YLLs) due to premature mortality. We reported these measures from 1990 to 2017 and stratified by region, socio-demographic index (SDI), gender and age group. Results: The latest IBD prevalence and burden estimates varied widely across regions, and were particularly elevated in high-SDI countries. Despite an increasing prevalence from 1990 to 2017 (+6%), the IBD burden decreased (DALYs −12%). This decrease was driven by IBD-associated premature mortality (YLLs −26%). This measure represented a high share of disease burden in low-SDI countries (86% of DALYs), whereas disability constituted the predominant component in high-SDI countries (71%) in 2017. Disease burden decreased particularly in children (DALYs −39% and YLLs −52%). In the last 10 years, however, prevalence plateaued in middle- to high-SDI countries and steeply increased in low-SDI countries. Conclusions: These findings highlight significant improvements in IBD care in the last three decades, particularly in children. The global burden of IBD and premature mortality have progressively decreased. The increase in disease frequency observed in developing countries is worrying, especially considering the high associated premature mortality in these areas.