0:00
This is Dr. Sunanda Kane,
Professor of Medicine
at Mayo Clinic College of Medicine
in Rochester, Minnesota.
And we're going to be talking
about Inflammatory Bowel Disease
and What the Internist Should Know.
0:12
Why should we be talking
about inflammatory bowel disease
to the internist?
Well, from 1998 to 2005,
there was a 450% increase in visits
to primary care by Crohn's patients
and 350% by ulcerative colitis patients.
In that timeframe,
there has been a decrease
in the use of steroids
and hospitalizations
for Crohn's patients as well as
for ulcerative colitis patients.
This means that primary care physicians
are doing a very good job
of treating these patients
and keeping them off of steroids
and keeping them out of the hospital.
0:48
There is an increasing incidence
and prevalence
of inflammatory bowel disease as well.
A systematic review with information
dating back to the 1920s,
showed a time trend analysis
where 75% of Crohn's studies
and 60% of ulcerative colitis studies
had an increasing incidence
of statistical significance.
The highest annual incidence
of ulcerative colitis
at 24 per 100,000 person years
is in Europe
and actually there is an incidence
now for Asia at 6.3 per 100,000.
The highest annual incidence
for Crohn's disease
is about 13 people per 100,000
in Europe and 5 now in Asia.
1:29
I often get asked about genetic testing.
Is inflammatory bowel disease
a genetic disorder?
Well, there are
now greater than 100 genes
associated with Crohn's disease
that have been identified.
These are candidate genes
not causative genes.
And the genetic information we have
has come from families with IBD,
not single cases.
So while genetic testing
is commercially available,
it needs to be
in conjunction with counseling
as there is not one single gene
that explains all of Crohn's disease
and certainly no single gene
explains ulcerative colitis.
