Inflammatory bowel disease in Asia; response to therapy

摘要

In the past 20 years the incidence of inflammatory bowel disease (IBD) has progressively increased in Asia, which gives a big challenge to clinicians for better management of the disease in this area due to lack of awareness, lack of knowledge of the disease, incompleteness of the Medicare system, and lack of sufficient financial support in most of the countries.Searching for the characteristics and responses to therapy, a review of literature from MEDLINE in the past 8 years in this area was undertaken. The data showed rather a small number of publications from this area, only 13.6% of the total number of publications throughout the world and even less original articles, accounting for 39.24% of total publications. There were also reviews, case reports and comments etc. The number of papers regarding basic science is similar to that of papers concerning treatment, with a slight tendency to increase. Most of the papers are from Japan, which accounts for more than half, with Israel, Australia, China, New Zealand, India and Korea next. To take Chinese literature as an example, less than 3% (36/1237) papers were published in English, implying that many of the studies are in their own language. From the therapeutic viewpoint principles and guidelines used in Asia are similar to those used in Western countries, but medication used is rather simple and basic for the majority of cases, with 5-ASA and corticosteroids predominant, as shown in Chinese hospital-based data (93.0% and 57.7% in ulcerative colitis (UC) and Crohn's disease (CD) respectively), probably because mild-moderate cases are predominant, or because of limitations in resources. Some complementary and alternative medicine (CAM) is used at the same time. Regarding responses to therapy, they are in general quite encouraging. The clinical course of IBD in this area seems to be less severe, with fewer complications, lower operation rate and lower mortality rate than those reported from Western countries.