Crohn's disease and ulcerative colitis have emerged as global diseases. They affect over 2 million individuals in the North America, 3.2 million in Europe, and millions more worldwide. The recent decades have been characterized by several important changes in the epidemiology of these diseases, in particularly an increasing incidence rates in newly industrialized countries experiencing a westernization of lifestyle. While rates of surgery have experienced a temporal decline attributable in part to increasing availability of medical treatments, earlier initiation of effective therapy, and changes in clinical practice, the healthcare costs associated with these diseases have continued to increase, in part due to costly therapies. Robust epidemiologic and experimental studies have defined the role of the external environment and microbiome on disease pathogenesis and have offered opportunities for disease prevention by modifying such factors. We propose several important steps that are necessary to provide globally sustainable inflammatory bowel disease care in the 21st century.

中文翻译：

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不断变化的全球炎症性肠病流行病学：持续进入21世纪的卫生保健。

克罗恩氏病和溃疡性结肠炎已成为全球性疾病。它们影响了北美的200万个人，欧洲的320万，以及全世界的数百万人。最近几十年来，这些疾病的流行病学发生了一些重要变化，尤其是在经历了生活方式西化的新兴工业化国家，其发病率不断上升。尽管手术率随时间下降，这部分归因于越来越多的医疗手段，更早开始有效的治疗以及临床实践的变化，但与这些疾病相关的医疗保健费用仍在继续增加，部分原因是昂贵的疗法。强大的流行病学和实验研究已经确定了外部环境和微生物组在疾病发病机理中的作用，并通过修改这些因素为疾病预防提供了机会。我们提出了几个重要步骤，这些步骤对于在21世纪提供全球可持续的炎症性肠病护理至关重要。