Inflammatory bowel disease (IBD). Epidemiology. both occur at the highest incidence in Europe, the United Kingdom, and North America. In North America, incidence rates range from 2.2 to 14.3 cases per 100,000 person-years for UC and from 3.1 to 14.6 cases per 100,000 person-years for CD.
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When the whole colon is involved, the inflammation extends 1–2 cm into the terminal ileum in 10–20% of patients. This is called backwash ileitis and is of little clinical significance.
Although variations in macroscopic activity may suggest skip areas, biopsies from normal-appearing mucosa are usually abnormal. Thus, it is important to obtainmultiple biopsies from apparently uninvolved mucosa, whether proximal or distal, during endoscopy.Effective medical therapy can change the appearance of the mucosa such that either skip areas or the entire colon can be microscopically normal
Gross and microscopic skip areas
Transmural inflammation that is accompanied by fissures that penetrate deeply into the bowel wall and sometimes form fistulous tracts or local abscesses.Crohn's Disease: Microscopic Features