Unfolding Crohn's Disease: History and Epidemiology

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The first Gastroenterologist to explain Crohn’s disease was not Burrill B Crohn; instead, the first narrative was probably made by Morgangni (1682-1771)(1). He described in 1761 a deceased young man with ileal ulceration and enlarged mesenteric lymph nodes. The entity of Crohn’s disease is , however, attributed to the Americal surgeon B B Crohn. He published in the Journal of American Medical Association in 1932, together with his collegues Leon Ginzburg and Gordon D Oppenheimer, the paper “ Regional ileitis’’: A Pathological and Clinical Entity’’ They meant that this disease was limited to the distal part of the ileum only , but in the forth coming year a description of jejuna disease was made by harris et. Al(2). Not until 1960, when Lockhart-Mummery John Snows considered as the originator of the modern epidemiology, explained the relationship between water supply and an outbreak of cholera in soho, London, in 1954. Epidemiological studies in Crohn’s disease have predominantly been made in North America and Europe. Usually the frequency has been raised since the 2nd World War not only for the ulcerative colitis but also for the Crohn’s disease, and two dissimilar patterns have appeared; one explain a steady increase, while the other has an increase followed by a plateau(6, 7).The highest incident is reported from North America , the United Kingdom and Scandinavia, and among Ashkenazi Jews(8-10). A North-South gradient has been reported both in North America and in Europe, with 40-80% raised risk in the northern part of the continents(11). However, there are part of southern Europe and North America with high incidence, and opposite in some northern region, which calls into question the north-south hypothesis. Instead an east-west gradient has been proposed which presently is topic of an epidemiological study (Epicom)(12). In Eastern Europe, the incidence of IBD appears to have raised steadily, now equivalent to that in western European countries(13, 14). The incidence is more uncertain in developing

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