Lui Rashid N S, Ng Siew C
Institute of Digestive Disease, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.
Inflamm Intest Dis. 2016 Jul;1(2):78-84. doi: 10.1159/000446625. Epub 2016 Jul 15.
Inflammatory bowel disease (IBD) is a chronic inflammatory disease with unknown etiology. It is likely caused by a complex interplay between genetic, immunologic and environmental factors. Although IBD is still relatively uncommon in Asia, a multitude of studies have shown that it is an emerging disease around the world. Recent insights have highlighted both the similarities and differences amongst Asian and Western IBD patients.
The annual incidence of IBD in the East is still low compared with the West, but there are differences between different regions of Asia. Time trend studies have shown that the incidence of IBD is on the rise. Some notable differences in the clinical manifestations of IBD between the East and West have also been noted. 'Westernization' of lifestyle may encompass various social and environmental changes that account for the emergence of IBD in our population, although genetics also plays a role in disease pathogenesis. Diagnosis and treatment challenges include limited access to medical care in certain areas, limited availability and high cost of medications, lack of insurance reimbursement, paucity of multidisciplinary teams for the management of complicated IBD cases, and a high prevalence of endemic infections. Currently, the risk of colorectal cancer is lower in the East than in the West, but cancer rates will likely approach that of the West in the future as the prevalence of IBD continues to rise.
Measures to improve access to diagnostic tools, increase the availability of medication, and provide adequate multidisciplinary care for IBD patients will become increasingly important in Asia. Differences between the East and West will provide a unique opportunity for global collaboration in basic and clinical research to further our understanding of the disease entity and also provide more locoregional data to healthcare providers and policymakers to make informed decisions and policy changes when tackling the rising burden of IBD in Asia.
炎症性肠病（IBD）是一种病因不明的慢性炎症性疾病。它可能是由遗传、免疫和环境因素之间复杂的相互作用引起的。尽管IBD在亚洲仍然相对不常见，但大量研究表明它在全球范围内是一种正在出现的疾病。最近的见解突出了亚洲和西方IBD患者之间的异同。
与西方相比，东方IBD的年发病率仍然较低，但亚洲不同地区之间存在差异。时间趋势研究表明IBD的发病率在上升。东西方IBD临床表现的一些显著差异也已被注意到。生活方式的“西方化”可能包括各种社会和环境变化，这些变化解释了IBD在我们人群中的出现，尽管遗传因素在疾病发病机制中也起作用。诊断和治疗面临的挑战包括某些地区获得医疗服务的机会有限、药物供应有限且成本高昂、缺乏保险报销、处理复杂IBD病例的多学科团队匮乏以及地方病感染的高流行率。目前，东方结直肠癌的风险低于西方，但随着IBD患病率的持续上升，未来癌症发病率可能会接近西方。
在亚洲，改善诊断工具的可及性、增加药物供应以及为IBD患者提供充分的多学科护理的措施将变得越来越重要。东西方之间的差异将为基础和临床研究的全球合作提供独特机会，以加深我们对疾病实体的理解，并为医疗保健提供者和政策制定者提供更多本地数据，以便在应对亚洲IBD负担不断上升的情况时做出明智的决策和政策调整。
