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[Comment] Rapid changes in epidemiology of inflammatory bowel disease

The prevalence of inflammatory bowel disease, that is Crohn’s disease and ulcerative colitis, has increased over two to three generations in high-income countries, but in only one generation (the past 25 years) in much of the newly industrialised and “developing” world. In China, for example, these conditions have changed from being rare to common and now account for the use of as much as a quarter of gastroenterological and colorectal surgical hospital beds.1 These diseases are not necessarily less severe initially; in developing countries inflammatory bowel disease has as severe a phenotype, with the same complications, morbidity, and mortality as in established patient populations in high-income countries.