Human epidemiology is the study of disease, its contributions and disparities, and potential ways to help stop the spread of disease. Among the West, there are many different diseases, viruses, prions, and other contagions that are incurable. Even among all the technology, in-depth research, and major complex studying among control variables, the West is still highly undeveloped; or, at least this is what one is lead to believe. However, there are many treatments, remission possibilities, and rehabilitation methods available. Among the many incurable diseases, Crohn’s disease has begun to resurface. This reappearance however, has been among children and teenagers not adults as witnessed in the past.
In the article entitled, “Pediatric Crohn’s Disease: Epidemiology, and Emerging Treatment Options”, Kansal and Smith explore Crohn’s disease and its affects globally on children ranging from 0-14 years of age. Crohn’s disease was first described as a clinical entity by Burrill B Crohn and colleagues in the USA in 1932 and has traditionally been regarded as a disease of the Western world. It is currently believed that Crohn’s disease occurs as part of interplay between environmental and immunological factors in a genetically susceptible host. A rising incidence in both adults and children has been observed in recent years, with some studies suggesting a ten-fold to 20-fold increase in children over three decades. Crohn’s disease currently affects about 700,000 people in the USA and about a million in Europe. It’s a disease that affects the gastrointestinal tract (gut), which eventually causes bone degradation and/or abnormal growth among young children. Researchers have even reported it to relate to IBD (inflammatory bowel disease). It would make sense seeing as if the gut includes the small intestine which assists in digesting nutrients to be distributed throughout the body. Moreover, if the first initial site of absorption is interrupted, proper bowel movement, as well as building healthy bones in development suffer traumatically.
While the peak age of new diagnosis for Crohn’s disease overall is between the second and fourth decades, the average age in pediatric practice is about 11 years. A study from Scotland reported a doubling of the incidence of pediatric Crohn’s disease over the 15-year period to 1995, with an overall averaged standardized incidence rate of 2.5 cases per 100,000 populations for the period. Marked increases in pediatric diagnoses have also been confirmed in other parts of Europe, such as Sweden, Czechoslovakia, and the UK, while elsewhere, such as Canada and the USA, they appear to have plateaued after previously documented increases.
One of the most interesting conclusions is that genetic susceptibility for Crohn’s disease is defined as how the host interacts with its microbiota. The search for a microbial trigger for Crohn’s disease has been carried out in two ways, either a specific transmissible agent or a dysbiosis involving the gastrointestinal microbial milieu. With this, researchers have found many treatment options. Most treatment options have been reared toward inflammation. Traditionally, the Step-Up treatment option was used for adults, but history of the disease along with uprising epidemic, a new method known as Top-down therapy is being administered to help with prevention of structural damage by achieving mucosal healing with this past use of immunosuppressants and biologicals. As mentioned, there is no cure for Crohn’s disease, but therapeutic interventions are designed to relieve symptoms, improve the quality of life, and avert-long-term complications.
Shavani Kansal, Anthony J. Smith (2014). Pediatric Crohn’s disease: epidemiology and emerging treatment options. Pediatric Health, Medicine and Therapeutic. University of Melborne.