Risk factors for inflammatory bowel disease in the general population

• BACKGROUND The aetiology of inflammatory bowel disease remains largely unknown. AIM We performed a comprehensive assessment of potential risk factors associated with the occurrence of inflammatory bowel disease. METHODS We identified a cohort of patients 20-84 years old between 1995 and 1997 registered in the General Practitioner Research Database in the UK. A total of 444 incident cases of IBD were ascertained and validated with the general practitioner. We performed a nested case-control analysis using all cases and a random sample of 10 000 frequency-matched controls. RESULTS Incidence rates for ulcerative colitis, Crohn's disease, and indeterminate colitis were 11, 8, and 2 cases per 100 000 person-years, respectively. Among women, we found that long-term users of oral contraceptives were at increased risk of developing UC (OR: 2.35; 95% CI: 0.89-6.22) and CD (OR: 3.15; 95% CI: 1.24-7.99). Similarly, long-term users of HRT had an increased risk of CD (OR: 2.60; 95% CI: 1.04-6.49) but not UC. Current smokers experienced a reduced risk of UC along with an increased risk of CD. Prior appendectomy was associated with a decreased the risk of UC (OR: 0.37; 95% CI: 0.14-1.00). CONCLUSIONS Our results support the hypothesis of an increased risk of inflammatory bowel disease associated with oral contraceptives use and suggest a similar effect of hormone replacement therapy on CD. We also confirmed the effects of smoking and appendectomy on inflammatory bowel disease.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)

Nyckelord

Adult

Aged

Aged; 80 and over

Anti-Inflammatory Agents; Non-Steroidal/adverse effects

Appendectomy/adverse effects

Aspirin/adverse effects

Contraceptives; Oral/adverse effects

Epidemiologic Methods

Female

Humans

Inflammatory Bowel Diseases/*epidemiology

Male

Middle Aged

Research Support; Non-U.S. Gov't

Smoking/adverse effects/epidemiology

Sweden/epidemiology

MEDICINE

MEDICIN

ulcerative-colitis

crohns-disease

smoking

appendectomy

epidemiology

association

depression

anxiety

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)