A Systematic Review and Meta-analysis of Paediatric Inflammatory Bowel Disease Incidence and Prevalence Across Europe

J Crohns Colitis. 2020 Sep 7;14(8):1119-1148. doi: 10.1093/ecco-jcc/jjaa037.

S E Roberts 1, K Thorne 1, N Thapar 2 3 4 5, I Broekaert 6, M A Benninga 7, J Dolinsek 8, E Mas 9 10, E Miele 11, R Orel 12 13, C Pienar 14, C Ribes-Koninckx 15, M Thomson 16, C Tzivinikos 17, S Morrison-Rees 1, A John 1, J G Williams 1


Author information

  • 1Medical School, Swansea University, Swansea, Wales, UK.
  • 2Neurogastroenterology and Motility Unit, Department of Gastroenterology, Great Ormond Street Hospital, London, UK.
  • 3Stem Cells and Regenerative Medicine, UCL Great Ormond Street Institute of Child Health, London, UK.
  • 4Prince Abdullah Ben Khalid Celiac Research Chair, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • 5Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Australia.
  • 6Department of Paediatrics, University Children's Hospital, University of Cologne, Cologne, Germany.
  • 7Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Amsterdam, The Netherlands.
  • 8Department of Pediatrics, University Medical Center Maribor, Maribor, Slovenia.
  • 9Unité de Gastroentérologie, Hépatologie, Nutrition, Diabétologie et Maladies Héréditaires, du Métabolisme, Hôpital des Enfants, CHU de Toulouse, Toulouse, France.
  • 10IRSD, Université de Toulouse, INSERM, INRA, ENVT, UPS, Toulouse, France.
  • 11Department of Translational Medical Science, Section of Pediatrics, University of Naples 'Federico II', Naples, Italy.
  • 12Department of Gastroenterology, Hepatology and Nutrition, Children's Hospital, University Medical Centre, 1000 Ljubljana, Slovenia.
  • 13Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia.
  • 14Department of Pediatrics, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Romania.
  • 15Department of Paediatric Gastroenterology, Hepatology & Nutrition, La FE University Hospital, Valencia, Spain.
  • 16Centre for Paediatric Gastroenterology, Sheffield Children's Hospital, Sheffield, UK.
  • 17Department of Paediatric Gastroenterology, Al Jalila Children's Specialty Hospital, Dubai, UAE.


Background and aims: Inflammatory bowel disease [IBD] is often one of the most devastating and debilitating chronic gastrointestinal disorders in children and adolescents. The main objectives here were to systematically review the incidence and prevalence of paediatric IBD across all 51 European states.

Methods: We undertook a systematic review and meta-analysis based on PubMed, CINAHL, the Cochrane Library, searches of reference lists, grey literature and websites, covering the period from 1970 to 2018.

Results: Incidence rates for both paediatric Crohn's disease [CD] and ulcerative colitis [UC] were higher in northern Europe than in other European regions. There have been large increases in the incidence of both paediatric CD and UC over the last 50 years, which appear widespread across Europe. The largest increases for CD have been reported from Sweden, Wales, England, the Czech Republic, Denmark and Hungary, and for UC from the Czech Republic, Ireland, Sweden and Hungary. Incidence rates for paediatric CD have increased up to 9 or 10 per 100 000 population in parts of Europe, including Scandinavia, while rates for paediatric UC are often slightly lower than for CD. Prevalence reported for CD ranged from 8.2 per 100 000 to approximately 60 and, for UC, from 8.3 to approximately 30.

Conclusions: The incidence of paediatric IBD continues to increase throughout Europe. There is stronger evidence of a north-south than an east-west gradient in incidence across Europe. Further prospective studies are needed, preferably multinational and based on IBD registries, using standardized definitions, methodology and timescales.

© Copyright 2013-2021 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.