García Rodríguez LA, González-Pérez A, Johansson S, Wallander MA

Risk factors for Inflammatory Bowel Disease in the general population.

Alimentary Pharmacology & Therapeutics. 2005;22:309-315

ABSTRACT


Background: The etiology of Inflammatory bowel disease (IBD) remains largely unknown.

Aim: We performed a comprehensive assessment of potential risk factors associated with the occurrence of IBD.

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 (UC), Crohns disease (CD), 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 IBD associated with oral contraceptives use and suggest a similar effect of Hormone Replacement Therapy (HRT) on CD. We also confirmed the effects of smoking and appendectomy on IBD.


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