IBD in East and Southeast Asia: The Lancet Gastroenterology & Hepatology | August 2026

Introduction:

Inflammatory bowel disease (IBD), historically concentrated in Western countries, is rapidly becoming a major healthcare challenge across East and Southeast Asia. This review examines a century of IBD evolution across Japan, South Korea, China, Hong Kong, and Malaysia and describes how the region is moving from rapidly increasing incidence toward compounding prevalence.

Why was this review needed?

Industrialisation and urbanisation have been accompanied by rapidly increasing IBD incidence across Asia.

IBD is a lifelong disease, so increasing incidence eventually creates a large cumulative population requiring long-term care.

Different Asian countries are progressing through the epidemiological transition at different speeds.

Understanding this trajectory is essential for future healthcare planning.

Key Takeaways:

IBD epidemiology follows four stages: emergence → accelerating incidence → compounding prevalence → prevalence equilibrium.

East and Southeast Asian regions are currently at different phases of the accelerating-incidence stage, with some approaching stage 3.

As incidence stabilizes, prevalence will continue increasing because younger patients diagnosed today will require decades of ongoing care.

Japan and other more industrialized Asian regions provide an early indication of what China, Malaysia, and other emerging regions may experience next.

Healthcare systems must prepare for increasing demand for specialist IBD care, advanced therapies, endoscopy, surgery, cancer surveillance, and long-term disease monitoring.

Clinical Impact:

The major future challenge for Asian IBD care may shift from managing rapidly increasing new diagnoses to supporting an ever-expanding population living with IBD. This transition requires long-term investment in multidisciplinary IBD services, registries, workforce, access to advanced therapies, and sustainable healthcare financing.

Bottom Line:

East and Southeast Asia are entering a new phase of the IBD epidemic: rising incidence is creating compounding prevalence. Even when incidence eventually stabilizes, the number of people living with IBD will continue to increase for decades, making healthcare-system preparedness an urgent priority.