S1869 Enigmatic Trends and Regional Disparities of Inflammatory Bowel Disease Across 204 Countries and Territories (1990-2021): Global Analysis From the Global Burden of Disease 2021

Introduction: Inflammatory Bowel Disease (IBD) is an emerging global health concern, with rising burden across diverse regions and populations. Once considered a disease of the Western world, IBD is now increasingly recognized worldwide. Understanding its distribution is vital for identifying risk factors, predicting trends, and developing effective strategies to manage its burden. Methods: We analyzed global burden of disease data to estimate incidence, prevalence, deaths, disability-adjusted life years (DALYs), and years lived with disability (YLDs). Rates (per 100,000) and annual percentage change (APC) were calculated for each variable. Comparative analysis was performed by age, gender, year, and region. Results: IBD prevalence rose from 2.17 million (95% UI: 1.90–2.53 million) in 1990 to 3.83 million (95% UI: 3.31–4.51 million) in 2021. China had the highest APC in prevalence rate (1.59%), while Italy had the greatest decline (0.75%). There were notable APC increases in Asian, African, and Latin American countries, indicating shifting global patterns. We compared age-standardized prevalence rates (ASPR) by economic status, revealing rates nearly 5 times higher in high-income countries (male: 127; female: 136) than in low- and middle-income nations The ASPR has also increased from 1990 to 2021 in nearly all economic groups. Age-standardized death and DALYs rates have declined over 3 decades (death rate: 0.6 in 1990 to 0.52 in 2021), though some peaks remain, reflecting ongoing management challenges. Incidence peaked around 2010 but has since slightly declined, possibly indicating improved detection and management. Age-group analysis of prevalence in 2021 A bell-shaped curve is revealed peaking at age 50–54 (male: 207k; female: 221k). Incidence shows a leftward shift, peaking at age 40–44 (male: 20k; female: 19k), suggesting a younger age of onset. Males have higher age-standardized death and DALYs rates than females. Conclusion: The rising prevalence and expanding distribution of IBD in low- and middle-income countries highlight the need for targeted public health efforts in regions with accelerating trends, to reduce disease burden and improve outcomes.