A Systematic Review on the Increasing Incidence of Inflammatory Bowel Disease in Southeast Asia: Looking Beyond the Urbanization Phenomenon

Author:

Chew Deborah Chia Hsin12,Khoo Xin-Hui3,Lee Tiong See4,Chin Kok-Yong5,Raja Ali Raja Affendi12,Muhammad Nawawi Khairul Najmi12,Wan Ibrahim Nik Razima6,Hilmi Ida3

Affiliation:

1. Gastroenterology and hepatology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia

2. GUT Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia , Kuala Lumpur , Malaysia

3. Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur , Malaysia

4. Department of Gastroenterology and Hepatology, Selayang Hospital , Kuala Lumpur , Malaysia

5. Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia

6. Gastroenterology and Hepatology Unit, Serdang Hospital , Selangor , Malaysia

Abstract

Abstract The incidence of inflammatory bowel disease (IBD) has been increasing in Southeast Asia (SEA) in tandem with its economic growth and urbanization over the past 2 decades. Specific characteristics of IBD in SEA are similar to East Asia and the West, such as the declining ratio of ulcerative colitis to Crohn’s disease. However, exceptionally low familial aggregation is seen. Smoking is also not a common risk factor in patients with Crohn’s disease. The incidence of perianal disease is higher in SEA than in Australia and is comparable to the West. In a multiracial population, such as Singapore and Malaysia, Indians have the highest incidence and prevalence rates, which are likely to be due to important putative mutations. For instance, a higher frequency of the NOD2 predisposing mutation SNP5 and IBD risk allele IGR2198a and IGR2092a were found in Indians. Although differences in the genetic constitution play an important role in the epidemiology and prognosis of IBD in SEA, the emergence of this disease offers a unique opportunity to identify potential exposomes that contribute to its pathogenesis.

Publisher

Oxford University Press (OUP)

Subject

Gastroenterology,Immunology and Allergy

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