This group is one of the UK’s leading gastrointestinal epidemiology research groups describing the epidemiology, aetiology and consequences of malignant and non-malignant acute and chronic gastrointestinal disease.

The group makes extensive use of e-health databases (CPRD, THIN, HES).

Major research contributions include:

  • evidence on the risk of venous thromboembolism in inflammatory bowel disease
  • the occurrence and consequences of diverticular disease
  • work in the field of liver disease, coeliac disease and gastrointestinal bleeding

Our work has informed national (British Society of Gastroenterology, NICE) and international (American Association for the Study of Liver Disease) guidelines on management of coeliac disease, inflammatory bowel disease, acute upper GI bleeding and primary biliary cirrhosis.

Gastrointestinal Epidemiology Studies

1. The occurrence, natural history and consequences of Inflammatory Bowel Disease

Study facts

  • Funder: National Association for Colitis and Crohn’s Disease (£100,000) Investigator: Tim Card Study dates: 2010-2012 Overview
  • Though much is known of the epidemiology of Inflammatory Bowel Disease (IBD), there are still large gaps in our knowledge, and some aspects including the most basic studies of prevalence and incidence need to be conducted repeatedly to be useful in the planning of health services.
  • Some of the outstanding questions can only be adequately addressed through large and expensive studies collecting new data. However with increasingly large quantities of ever richer data available in anonymised databases; database epidemiology provides a relatively fast and reliable method to answer many others.


  1. To determine the prevalence and incidence of IBD and its variation by type, sex, age, socioeconomic status and geographical distribution in the UK. 
  2. To describe the natural history and progression of disease in terms of the rates of acute flare, burden of steroid use, and rates of surgical intervention. 
  3. To quantify the risk of venous thromboembolism in people with IBD compared with the general population and how this is related to episodes of disease activity, hospitalisation, surgical intervention and comorbidity. 
  4. To determine the fertility rate of women with IBD and the occurrence of complications of pregnancy and congenital anomalies and how this is related to severity of disease and medication use. 


Using the General Practice Research Database, linked to Hospital Episodes Statistics and the Office for National Statistics data on births, cancer and deaths, population-based cohorts will be obtained to enable aims 1-3 to be examined addressed. A further cohort from the mother-baby linked dataset of The Health Improvement Network will be obtained to address aim 4

2. What is the health care burden of chronic liver disease in the UK?

Study facts

  • Funder: School of Community Health Sciences PhD Studentship
  • Investigator: Sonia Ratib
  • Study dates: 2011-2014


  1. What is the incidence and prevalence of cirrhosis of the liver in the UK over the previous 2 decades and how does this vary by age, sex, socioeconomic status, geographical region and aetiology of disease?
  2. What is the rate of hepatocellular carcinoma among people with cirrhosis and how does it compare to that of the general population?
  3. What are the rates and reasons for hospital admission among people with chronic liver disease compared to the general population?
  4. Can prognostic scores for end-stage liver disease designed in secondary care be adapted and used in primary care, using routinely available data?


We will identify cohorts of people with chronic liver disease and a matched cohort of people without chronic liver disease from the General Practice Research Database. Secondary care and national statistics data linked to these cohorts will be obtained and together provide all the necessary information to characterise the populations in great detail alongside the natural history of the disease.

This will include data describing the primary care attendances, hospital admissions, cancer diagnosis date, type, site and histology where available and cause of death.

For more information on Gastrointestinal Epidemiology click here

Photo Name Bio
Dr Tim Card Dr Card studied medicine in Bristol, and received his postgraduate medical training in Leicester and Oxford. He completed a PhD in Nottingham, and after completion of his clinical training returned as Clinical associate Professor.
dr-colin-crooks Dr Colin Crooks Colin Crooks completed his undergraduate degree in Bachelor of Medicine, Bachelor of Surgery (BMBS) and B.Med.Sci (Hons) at University of Nottingham, before going on to receive his Diploma MRCP (UK) Royal College of Physicians and MSc in Epidemiology at…
Dr David Humes I am currently using linked GPRD and HES data to study the epidemiology of diverticular bleeding and femoral hernia.