Risk factors for inflammatory bowel disease: A prospective multi-center study
- 299 Downloads
Environmental risk factors have been associated with inflammatory bowel disease (IBD). With rising incidence, it is important to know risk factors associated with IBD in our population. This study was aimed to evaluate risk factors for IBD from western India.
This was prospective, multi-center case-control study which included 1054 patients with IBD of which 765 (72.5%) were ulcerative colitis (UC) and 289 (27.4%) Crohn’s disease (CD). Asymptomatic individuals without a history of any major illness served as controls. The questionnaire containing risk factors for IBD was given to patients and control group. Odds ratio and 95% confidence interval were calculated for each variable.
Significant numbers of patients with CD were from rural area. Rural environment (OR 1.071, 0.82–1.38 and OR 1.441, 1.02–2.02), higher education (OR 1.830, 1.52–2.19 and OR 1.519, 1.16–1.97), professional by occupation (OR 1.754, 1.46–2.09 and OR 1.293, 0.99–1.67), annual family income >100,000 Indian national rupees (OR 2.185, 1.52–3.13 and OR 4.648, 3.10–6.95), history of appendectomy (OR 3.158, 1.71–5.80 and OR 3.158, 1.71–5.80), and family history of IBD (OR 4.510, 2.19–9.25 and OR 3.972, 1.58–9.96) were the risk factors for UC and CD, respectively. Vegetarian diet was protective factor for UC (OR 0.29, 0.27–0.39) and risk for CD (OR 1.179, 0.88–1.57). Smoking and chronic alcoholism were not found to be the risk factors.
This study highlights association between socioeconomic, dietary factors, appendectomy, and family history as risk factors for IBD.
KeywordsCrohn’s disease Extraintestinal manifestations Ulcerative colitis
Compliance with ethical standards
Conflict of interest
ADA, DNA, PR, PS, NP, PK, KR, RB, AS, NN, SK, and NT declare that they have no conflict of interest.
The authors declare that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.
- 4.Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology. 2012;142:46–54.e42.Google Scholar
- 8.Dolan KT, Chang EB. Diet, gut microbes, and the pathogenesis of inflammatory bowel diseases. Mol Nutr Food Res. 2017;61: https://doi.org/10.1002/mnfr.201600129.
- 14.Amarapurkar DN, Patel ND, Rane PS. Diagnosis of Crohn’s disease in India where tuberculosis is widely prevalent. World J Gastroenterol. 2008;14:741–6.Google Scholar
- 17.Sood A, Amre D, Midha V, A, et al. Low hygiene and exposure to infections may be associated with increased risk for ulcerative colitis in a North Indian population. Ann Gastroenterol. 2014;27:219–23.Google Scholar
- 21.Wang YF, Ou-Yang Q, Xia B, et al. Multicenter case-control study of the risk factors for ulcerative colitis in China. World J Gastroenterol. 2013;19:1827–33.Google Scholar
- 22.Ng SC, Tang W, Leong RW, et al. Environmental risk factors in inflammatory bowel disease: a population-based case-control study in Asia-Pacific. Gut. 2015;64:1063–71.Google Scholar
- 25.Ananthakrishnan AN, Khalili H, Song M, et al. High school diet and risk of Crohn’s disease and ulcerative colitis. Inflamm Bowel Dis. 2015;21:2311–9.Google Scholar
- 27.Kuenzig ME, Lee SM, Eksteen B, et al. Smoking influences the need for surgery in patients with the inflammatory bowel diseases: a systematic review and meta-analysis incorporating disease duration. BMC Gastroenterol. 2016;16:143.Google Scholar
- 28.Lunney PC, Kariyawasam VC, Wang RR, et al. Smoking prevalence and its influence on disease course and surgery in Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther. 2015;42:61–70.Google Scholar
- 29.Calkins BM. A meta-analysis of the role of smoking in inflammatory bowel disease. Dig Dis Sci 1989;34:1841–54.Google Scholar
- 30.Bernstein CN, Wajda A, Svenson LW, et al. The epidemiology of inflammatory bowel disease in Canada: a population-based study. Am J Gastroenterol. 2006;101:1559–68.Google Scholar
- 31.Bergmann MM, Hernandez V, Bernigau W, et al. No association of alcohol use and the risk of ulcerative colitis or Crohn’s disease: data from a European Prospective cohort study (EPIC). Eur J Clin Nutr. 2017;71:512–8.Google Scholar
- 32.Jiang L, Xia B, Li J, et al. Risk factors for ulcerative colitis in a Chinese population: an age-matched and sex-matched case-control study. J Clin Gastroenterol. 2007;41:280–4.Google Scholar
- 39.Kevans D, Silverberg MS, Borowski K, et al. IBD genetic risk profile in healthy first-degree relatives of Crohn’s disease patients. J Crohns Colitis. 2016;10:209–15.Google Scholar
- 41.Isene R, Bernklev T, Høie O, et al. Extraintestinal manifestations in Crohn’s disease and ulcerative colitis: results from a prospective, population-based European inception cohort. Scand J Gastroenterol. 2015;50:300–5.Google Scholar