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 16 years) was recorded from a prospective database for a geographically-defined area of Southern England (2002–2012). Data was 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 survey in 1998/9. Data was 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 (1998–99) 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 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 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 both 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 Wessex. The reasons for this increase are unclear and although they may partly reflect earlier diagnosis and improved referral patterns are likely also to reflect a genuine rise in new cases.