Internal medicine notes

Apr 16th, 2015
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Inflammatory bowel disease(IBD)Epidemiology both occur at the highest incidence inEurope, the United Kingdom, and NorthAmerica. In North America, incidence rates rangefrom 2.2 to 14.3 cases per 100,000person-years for UC and from 3.1 to 14.6cases per 100,000 person-years for CDEpidemiology The peak age of onset of UC and CD is between15 and 30 years. A second peak occurs between the ages of 60and 80. The male to female ratio for UC is 1:1 and forCD is 1.11.8:1. UC and CD have two- to fourfold increasedfrequency in Jewish populations in the UnitedStates, Europe, and South AfricaEpidemiology Urban areas have a higher prevalence ofIBD than rural areas high socioeconomic classes have ahigher prevalence than lowersocioeconomic classes.Epidemiology The risk of UC in smokers is 40% that ofnonsmokers. Additionally, former smokers havea 1.7-fold increased risk for UC than peoplewho have never smoked. In contrast, smoking is associated with atwofold increased risk of CD. Oral contraceptives are also linked to CD; theodds ratio of CD for oral contraceptive users isabout 1.4. Appendectomy is protective against UC butincreases the risk of CD.Epidemiology If a patient has IBD, the lifetime risk that a first-degreerelative will be affected is ~10%. If two parents have IBD, each child has a 36% chance ofbeing affected. In twin studies, 58% of monozygotic twins areconcordant for CD and 6% are

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