Academic Stress May Contribute to the Onset of Pediatric Inflammatory Bowel Diseases

Krishna, Mahesh; Barton, Keisha R.; Perez, Carla; Walsh, Seema M.; Assa, Amit; Kellermayer, Richárd

doi:10.1097/mpg.0000000000002032

Cited by 13 publications

(8 citation statements)

References 22 publications

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“…For the time of birth analyses, no overall association with season or month of birth was found, somewhat in contrast to other [25][26][27][29][30][31][35][36][37]39,40] but not all studies [24,28,[32][33][34]38]. However, we did find that that the fortification policy might have been especially beneficial for individuals born in autumn.…”

Section: Discussioncontrasting

confidence: 94%

“…Several studies have investigated the association between month or season of birth and IBD development with inconsistent results [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Month or season of birth can indicate different environmental exposures during gestation and infancy, e.g., sunshine hours as a proxy for vitamin D exposure, or infections, and/or use of antibiotics.…”

Section: Introductionmentioning

confidence: 99%

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Prenatal and Early Life Exposure to the Danish Mandatory Vitamin D Fortification Policy Might Prevent Inflammatory Bowel Disease Later in Life: A Societal Experiment

et al. 2021

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This register-based national cohort study of 206,900 individuals investigated whether prenatal exposure to small extra doses of vitamin D from fortified margarine prevented inflammatory bowel disease (IBD) later in life; whether the risk of IBD varied according to month or season of birth; and finally, whether there was an interaction between exposure to extra D vitamin and month or season of birth. Fortification of margarine with vitamin D was mandatory in Denmark from the mid-1930s until 1st June 1985, when it was abolished. Two entire birth cohorts, each including two years, were defined: one exposed and one unexposed to the fortification policy for the entire gestation. All individuals were followed for 30 years from the day of birth for an IBD diagnosis in Danish hospital registers. Logistic regression analyses were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Odds for IBD was lower among those exposed to extra D vitamin compared to those unexposed, OR = 0.87 (95% CI: 0.79; 0.95). No association with month or season of birth was found. However, estimates suggested that particularly children born during autumn may have benefitted from the effect of small extra doses of vitamin D. This is, to our knowledge, the first study to explore if prenatal exposure to vitamin D from fortification influenced the risk of IBD. Our results suggest that prenatal exposure to small amounts of extra vitamin D from food fortification may protect against the development of IBD before 30 years of age.

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Section: Discussioncontrasting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Prenatal and Early Life Exposure to the Danish Mandatory Vitamin D Fortification Policy Might Prevent Inflammatory Bowel Disease Later in Life: A Societal Experiment

et al. 2021

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“…24 In a recent study, academic stress was implicated in the onset of IBD in susceptible children. 25 A previous study found that exposure to pets, especially dogs and cats protected against the development of IBD. 26 Similarly, a population-based Asian study by Ng et al 14 found that exposure to pet dogs and fish were protective factors for development of adult IBD.…”

Section: Discussionmentioning

confidence: 97%

“…The proposed pathophysiologic pathway includes that of the autonomic nervous system, hypothalamic–pituitary–adrenal axis, microbiota brain‐gut axis and the immune system 24 . In a recent study, academic stress was implicated in the onset of IBD in susceptible children 25 …”

Section: Discussionmentioning

confidence: 99%

Environmental risk factors for inflammatory bowel disease: A case control study in Southeast Asian children

Lee

Song

Wong

et al. 2021

J Paediatrics Child Health

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Aim Early‐life environmental exposure, which has important implications in the pathogenesis of inflammatory bowel disease (IBD), is not well understood in Asian children. We examined environmental factors prior to the development of childhood IBD in a Southeast Asian population. Methods We conducted a case control study in IBD diagnosed before 18 years of age and controls matched by gender, age and ethnicity. A questionnaire recording medical, family, dietary and social histories, home environment, childhood diseases and immunisation status was used. Results In a multivariate analysis involving 70 children with IBD (Crohn's disease (CD) = 38; ulcerative colitis (UC) = 32) and 140 controls, childhood acute gastroenteritis (odds ratio (OR): IBD 6.9; CD 7.8; UC 5.8) and excessive antibiotic usage in early childhood (OR: IBD 5.3; CD 4.2; UC 4.8) were significantly associated with IBD, CD and UC. Having a fish or turtle aquarium (OR 6.0), major stressful life events (OR 5.6) and attending the same school concurrently with a sibling (OR 2.9) were significant risk factors for IBD. Duration of breastfeeding >6 months (OR: IBD 0.4; UC 0.2) and safe water consumption (OR: IBD 0.2; UC 0.2) reduced the odds of having IBD and UC, respectively. Being vaccinated for rotavirus reduced the odds of developing IBD (OR 0.1). Conclusions Several risk and protective factors were identified in this environmental risk study in Southeast Asian children with IBD. This knowledge has important implications in understanding disease aetiology and future prevention strategies to reduce the development of IBD in Southeast Asian children.

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“…Researchers analyzed the relationship between the annual rhythm of IBD symptom onset and academic semesters in children. The results showed that academic stress may facilitate disease onset in pediatric IBD (82).…”

Section: Interaction Between Stress and Ibdmentioning

confidence: 98%

Stress Triggers Flare of Inflammatory Bowel Disease in Children and Adults

et al. 2019

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Inflammatory bowel disease (IBD) is an idiopathic inflammatory disease characterized by chronic and relapsing manifestations. It is noteworthy that the prevalence of IBD is gradually increasing in both children and adults. Currently, the pathogenesis of IBD remains to be completely elucidated. IBD is believed to occur through interactions among genetics, environmental factors, and the gut microbiota. However, the relapsing and remitting course of IBD underlines the importance of other modifiers, such as psychological stress. Growing evidence from clinical and experimental studies suggests that stress acts as a promoting or relapsing factor for IBD. Importantly, recent studies have reported an increasing incidence of anxiety or depression in both children and adults with IBD. In this article, we review the mechanisms by which stress affects IBD, such as via impaired intestinal barrier function, disturbance of the gut microbiota, intestinal dysmotility, and immune and neuroendocrine dysfunction. With regard to both children and adults, we provide recent evidence to describe how stress can affect IBD at various stages. Furthermore, we emphasize the importance of mental healing and discuss the value of approaches targeting stress in clinical management to develop enhanced strategies for the prevention and treatment of IBD.

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Academic Stress May Contribute to the Onset of Pediatric Inflammatory Bowel Diseases

Cited by 13 publications

References 22 publications

Prenatal and Early Life Exposure to the Danish Mandatory Vitamin D Fortification Policy Might Prevent Inflammatory Bowel Disease Later in Life: A Societal Experiment

Prenatal and Early Life Exposure to the Danish Mandatory Vitamin D Fortification Policy Might Prevent Inflammatory Bowel Disease Later in Life: A Societal Experiment

Environmental risk factors for inflammatory bowel disease: A case control study in Southeast Asian children

Stress Triggers Flare of Inflammatory Bowel Disease in Children and Adults

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