Canadian children suffer highest rate of painful bowel diseases in the world.
By LESLEY YOUNG
Children born in Canada face higher risks of developing an inflammatory bowel disease (IBD) than anywhere else in the world, according to a massive 10-year study that revealed rising rates among children under 16 years old.
“This a major disease issue. In some respects, the rates of IBD are on par with diabetes,” said Matthew Carroll, University of Alberta pediatric gastroenterologist and the Alberta lead on the national study.
Symptoms to watch for
Pediatric gastroenterologist Matthew Carroll recommends that parents seek out specialist care for any infant or child who experiences
“IBD are a group of chronic, lifelong debilitating diseases that include Crohn disease and ulcerative colitis. In addition to causing physical pain and damage, they can affect normal growth and development of children,” he explained.
Carroll played a founding role in developing the Canadian Gastrointestinal Epidemiology Consortium to allow standardized national analysis of IBD. The study’s findings were surprising, he added, even though researchers knew rates of IBD among children have been increasing over the last 20 years.
“Our study showed Canada has amongst the highest rates of pediatric IBD in the world, with 9.7 per 100,000 children.”
Rates varied by province: Manitoba was among the lowest rates, and Nova Scotia the highest. Alberta was in line with the national average.
The rising rates among the young—a 60 per cent overall increase in children under 16 and a 7.2 per cent per year increase in children under five—suggests those early years of life as well as geography play an important role in developing the disease, Carroll noted.
Getting IBD young often means more severe disease, and greater risk of disease complications such as liver disease, disabling joint inflammation and increased risk of cancer in some patients, said Carroll.
“IBD also has massive impacts on quality of life, ranging from the need to rush to the toilet urgently, to living with chronic pain, missing school and the need for possible hospitalizations and surgery. Family impact can also be significant with time off work for parents.”
Canada’s high risk
Researchers aren’t sure how Canada’s geography or environment play a role. But Carroll said theories include low vitamin D due to low sunlight exposure, diet, air pollution, antibiotic exposure and ethnic migration patterns.
“Genetics does play a role. But it seems that these early influences—as well as exposure to different infections, both getting them and not getting them—impact the evolving microbial environment in the body,” said Carroll.
He added there’s a lot of research currently underway to identify potential triggers and environmental risk, as well as genetic influences.
“In time, identifying and manipulating the environment and diet is going to be important for prevention and treatment. That’s why we urge anyone with a diagnosis to participate in research, if asked.”
The Edmonton Pediatric IBD Clinic (EPIC) at the Stollery Children’s Hospital plays a leading role in research recruitment, as do other Western Canadian hospitals, he added.
What parents can do
Unfortunately, there isn’t any known way to prevent children from developing IBD.
“The causes are complicated. Depending where you live, the way in which bacteria populate the gut in some environments plays a role,” said Carroll. “If there is a family history, it’s important to be mindful of that and seek out help early.”
There is no known cure for IBD, “but we do have good treatments for IBD,” he said. “If you treat IBD properly, and treat it early, you can get the bowel to heal and ideally prevent long-term complications and the need for surgery.”
Carroll said a goal of this research is to help raise awareness among family physicians and pediatricians, and encourage referral to a pediatric gastroenterologist.
“Because pediatric IBD is challenging to treat, there is strong evidence it needs to be managed by a specialist. EPIC tends to pediatric patients from Saskatchewan, northern B.C. and northern Alberta.”