An investigation of the inflammatory bowel diseases: their epidemiology, associations and outcomes

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King, Dominic S (2021). An investigation of the inflammatory bowel diseases: their epidemiology, associations and outcomes. University of Birmingham. M.D.

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Abstract

Background
The inflammatory bowel diseases (IBD), incorporating Crohn’s disease (CD) and ulcerative colitis (UC), cause significant morbidity. The aims of this thesis were to explore the UK IBD burden; the outcomes of first acute UC admissions and further surgery risk in CD; and the risk of an IBD diagnosis in those presenting with an extraintestinal manifestation (EIM) of IBD.

Methods
Retrospective cohort studies (cross-sectional for prevalence estimates) in national primary and secondary care databases were used to examine the epidemiology and outcomes of subjects with IBD or those presenting with associated conditions.

Results
These studies demonstrated an increasing prevalence alongside a stable incidence of IBD in UK adults. Increased mortality and colorectal cancer (CRC) risk was observed in those with IBD compared to age/sex-matched controls. Subjects presenting with ophthalmic or dermatological EIMs were at increased risk of subsequently being diagnosed with IBD. Mortality during a first acute UC admission and within 12-months were low and colectomy rates in this group are falling over time. Further surgery in CD remains common although when increasing prevalence is accounted for, index resections appear to be falling.

Conclusions
IBD constitutes a significant disease burden in the UK and increasing prevalence will demand greater resources.

Type of Work:

Thesis (Doctorates > M.D.)

Award Type:

Doctorates > M.D.

Supervisor(s):