Rising burden of inflammatory Bowel disease in Northeastern Italy: a population-based analysis of prevalence and incidence trends from 2012 to 2024.

BACKGROUND: Inflammatory bowel disease (IBD) has undergone epidemiological transformation globally, with Western Europe in compounding prevalence. Comprehensive population-based data from Southern Europe remain limited. AIMS: To describe IBD epidemiology in Northeastern Italy and analyse temporal trends from 2012 to 2024. METHODS: Retrospective population-based study in the Veneto region (∼4.9 million residents) using linked hospital discharge records and healthcare exemption registries. Cases were identified by ICD-9-CM codes (555.* for Crohn's disease, 556.* for ulcerative colitis). Point prevalence was calculated annually (2012-2024) and incidence from 2013 to 2024. Temporal trends were analysed using Joinpoint regression with annual percentage change. RESULTS: We identified 29,388 prevalent cases (9,656 Crohn's disease, 18,375 ulcerative colitis) and 14,737 incident cases. Crohn's disease prevalence rose 76% (0.95 to 1.67 per 1,000), with annual changes of 5.38% (2012-2018) and 4.14% (2018-2024). Ulcerative colitis prevalence rose 58% (1.97 to 3.11 per 1,000) across three deceleration phases. Crohn's disease incidence increased steadily (2.63% annually); ulcerative colitis showed biphasic dynamics with post-2020 acceleration. Both subtypes demonstrated consistent male predominance and cohort aging. CONCLUSION: Northeastern Italy has experienced substantial increases in IBD burden, positioning the region among higher-burden Southern European areas and underscoring the need for resource planning and prevention strategies.