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Inflammatory Bowel Disease
GMJ News knowledge hub · last reviewed August 2026 · Georgian Medical Journal
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Inflammatory bowel disease (IBD) — encompassing Crohn's disease and ulcerative colitis — affects approximately 6.8 million people globally and is rapidly increasing in LMICs as they adopt Western lifestyle and dietary patterns, representing a new epidemic in regions where it was historically rare (WHO/Lancet). IBD causes chronic, relapsing intestinal inflammation, severe abdominal pain, diarrhoea, bleeding and — over decades — bowel damage, cancer risk and disability. The biologic therapy revolution — TNF inhibitors, vedolizumab, ustekinumab and JAK inhibitors — has transformed outcomes for patients with access to these agents.
Key messages
6.8 million worldwide — rising globally
IBD affects approximately 6.8 million people globally and is rapidly increasing in LMICs as they adopt Western lifestyles — transitioning from a disease of high-income countries to a truly global epidemic (Lancet Gastroenterology 2020).
Two main conditions
IBD encompasses Crohn's disease (transmural inflammation affecting any part of the GI tract — from mouth to anus) and ulcerative colitis (mucosal inflammation limited to the colon). Both cause chronic relapsing inflammation with significant disability.
Biologic revolution
TNF inhibitors (infliximab, adalimumab), vedolizumab, ustekinumab, JAK inhibitors (tofacitinib, filgotinib) and IL-23 inhibitors (risankizumab) have transformed IBD management — achieving mucosal healing and sustained remission in the majority of patients when treated early and aggressively.
Colorectal cancer risk
Long-standing ulcerative colitis (particularly pan-colitis >8-10 years) significantly increases colorectal cancer risk. Surveillance colonoscopy every 1-5 years is standard of care. Optimising inflammation control (mucosal healing) reduces cancer risk.
Microbiome central
IBD arises from an aberrant immune response to gut microbiota in genetically susceptible individuals. Disrupted gut microbiome composition is a consistent finding. Faecal microbiota transplantation (FMT) is effective for UC in clinical trials and may become a treatment option.
Young people most affected
IBD typically presents in young adults aged 15-35 — during their most productive years. The social, educational and occupational impact is enormous. IBD is associated with depression and anxiety at 2-3x higher rates than the general population.
Key statistics
IBD prevalence (per 100,000 population) by region — Lancet Gastroenterology 2020
Glossary of key terms
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Colorectal cancerMental healthNutritionChronic painRare GI conditionsSocial determinants
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