Current status of inflammatory bowel diseases in Korea

Background: Inflammatory bowel disease (IBD) is a disease of unknown origin that causes chronic inflammation of the intestines and is classified as either ulcerative colitis or Crohn’s disease. The incidence and prevalence of IBD in Korea have been rapidly increasing during the past three decades. This paper describes the current status of IBD in Korea.Current Concepts: Compared with western countries, genotypes and phenotypes of IBD in Korea demonstrate some distinct features, which may have an impact on the diagnosis, treatment, and prognosis of IBD. We continue to experience some difficulties in making early and accurate diagnoses of IBD in Korea due to a low awareness of the disease and the high prevalence of infectious enterocolitis, such as intestinal tuberculosis, which needs to be differentiated from IBD. The treatment of IBD can be influenced by differences in genetic, environmental, and social factors. NUDT15 variants limit the use of thiopurines. Infectious diseases, including tuberculosis, hepatitis B, and cytomegalovirus colitis, are usually more common in Asia than in western countries and can adversely influence the management of IBD. Biologic agents, which have changed the treatment paradigm of IBD, are equally efficacious in Asian patients as in Western patients. However, their use is limited due to a strict Korean government health insurance reimbursement policy. The prognosis of ulcerative colitis in Korea may be better than that in western countries, as indicated by a lower colectomy rate. However, this difference is less distinct in Crohn’s disease.Discussion and Conclusion: IBD in Korea differs from that in western countries in many respects. With rapid increase in the prevalence of IBD in Korea, medical costs for IBD are expected to become a significant financial burden. Koreans need to be prepared for this eventuality.