Researchers trying to figure out the role genetics, geography and environment play in surprising finding.
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.

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.”

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.”