Background There has been a significant increase in the incidence of paediatric inflammatory bowel disease (PIBD) over the last 25 years although there is no recent data from England. We aimed to analyse changes in incidence within a defined English population over the last decade and compare this to recent and historical incidence data from comparable studies.

Methods The new diagnosis incidence of PIBD (age less than or equal to 16 years) was recorded from a prospective database for a geographically defined area within Southern England (2002–2012). Data were analysed for two separate time periods (cohort 1:2002–2006 and cohort 2:2008–2012) and compared to data from the British Paediatric Surveillance Unit (BPSU) survey in 1998/1999. Data were analysed by age, sex and disease type.

Results There has been an increase in incidence of PIBD from 6.39/100 000/year during cohort 1 to 9.37/100 000/year during cohort 2 (p=0.0002). This compares with the BPSU incidence data in England (1998–1999) of 5.2/100 000/year. There was no statistically significant difference in median age of diagnosis between cohorts (p=0.46).

The incidence of Crohn's disease (CD) was 3.8/100 000/year in cohort 1 rising to 5.85/100 000/year in cohort 2 (p=0.001). The incidence of ulcerative colitis (UC) was 2.01/100 000/year in cohort 1 rising to 2.62/100 000/year in cohort 2 (p=0.1458). Overall PIBD incidence is higher in males in cohort 1 (male-to-female ratio 1.35:1) and cohort 2 (male-to-female ratio 1.5:1).

Conclusions The incidence of PIBD continues to increase with a rise of almost 50% in the last decade in Southern England. The reasons for this increase remain unclear.