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Incidence and Phenotypic Characteristics of Pediatric IBD in Northeastern Slovenia, 2002–2010

Urlep, Darja*; Trop, Tina K.*; Blagus, Rok; Orel, Rok*

Journal of Pediatric Gastroenterology and Nutrition: March 2014 - Volume 58 - Issue 3 - p 325–332
doi: 10.1097/MPG.0000000000000207
Original Articles: Gastroenterology

Objectives: The purpose of the present study was to determine the incidence of inflammatory bowel disease (IBD) and its subgroups in children in northeastern Slovenia (NE Slovenia) during the period 2002–2010, and to assess the phenotypic characteristics at the diagnosis and during the follow-up.

Methods: A retrospective investigation was conducted on a cohort of newly diagnosed children and adolescents with IBD ages 0 to 18 years between 2002 and 2010 and residing in NE Slovenia. The phenotypic characteristics were determined at presentation and during follow-up. The location of Crohn disease (CD) and ulcerative colitis (UC) was assessed according to the Paris classification at diagnosis, and later in patients who had a follow-up period >2 years. The type of therapy at diagnosis and during follow-up, and the need for surgery were determined. The study covered approximately one-third of the total pediatric population (0–18 years).

Results: In total, 107 cases of IBD were diagnosed during the study period. The mean annual incidence (per 100,000) was 7.6 (95% confidence interval [CI] 6.3–9.2) for all IBD, 4.6 (95% CI 3.6–5.9) for CD, and 2.8 (95% CI 1.9–3.8) for UC. The incidences of total IBD, CD, and UC increased from 5.7 (3.8–8.2), 3.9 (2.3–6.1), and 1.8 (0.8–3.5) in the period 2002–2004, respectively, to 8.9 (6.3–12.2), 5.0 (3.1–7.6), and 3.4 (1.9–5.6) in the period 2008–2010, respectively. During the follow-up, the proportion of complicated CD disease behavior (stricturing/penetrating) had doubled. A total of 18.5% of patients with CD underwent bowel surgery.

Conclusions: The incidence of childhood IBD in the northeastern part of the country is high and comparable with that reported from the developed western countries of Europe, and is probably still increasing. This increase may be the result of changes in the lifestyle, especially in dietary habits during the last 20 years.

*Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital Ljubljana, University Medical Center Ljubljana

Faculty of Medicine, Institute for Biostatistics and Medical Informatics, University of Ljubljana, Ljubljana, Slovenia.

Address correspondence and reprint requests to Prof Rok Orel, MD, PhD, Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital Ljubljana, Bohoričeva 20, 1000 Ljubljana, Slovenia (e-mail:

Received 9 October, 2013

Accepted 9 October, 2013

The authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,