Most children with ulcerative colitis present between the ages of 10 and 18 years. However, ulcerative colitis in children under the age of 5 years is well described.1,4,5 Epidemiological studies primarily conducted in the US, GB, and Scandinavian countries, suggest that the incidence of ulcerative colitis in children ranges from 1.4 to 4.3 cases/100 000 population per year.3,6-10 The incidence of ulcerative colitis in children has remained relatively stable11 (Table 25.1). The majority of incidence data for Crohn's disease and ulcerative colitis in the pediatric population originates from geographic regions with higher rates of IBD.

Adult studies demonstrate that ulcerative colitis is more prevalent in North America, the UK, and Scandinavia and less common in southern Europe, Asia and Africa.2 The data suggest a north-south gradient with higher incidence rates of both Crohn's disease and ulcerative colitis in northern locations, even within individual countries.12,13 Ulcerative colitis is more common among Jewish than non-Jewish peoples,14 but disease rates in people of Jewish origin vary by geographic region and parallel those of the general population.15 The higher rates of IBD in individuals of Jewish origin across different countries support a common genetic predisposition; however, the geographic variation of IBD rates in Jews emphasizes that environmental factors (see below) influence the inherited risk.

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