Environmental risk factors and Crohn's disease: a population-based, case-control study in Spain

Sicilia, Beatriz; Miguel, C. López; Arribas, Francisco Javier Rubio; Zaborras, J. López; Sierra, E.; Gomollón, Fernando

doi:10.1016/s1590-8658(01)80693-9

Cited by 33 publications

(18 citation statements)

References 22 publications

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“…Amre et al (2006) created a 'crowding index' which refers to the number of rooms in the home divided by the number of inhabitants living in the home and found the mean 'crowding index' to be lower in cases than controls and thus protective against CD [22] . No differences however were found between the numbers of people residing in the home during infancy (< 18 years) in IBD patients versus controls [87] , although this study had limited power. Siblings may influence the development of IBD by altering exposure patterns to microorganisms in early life by affecting acute manifestation of infection by influencing age of transmission and severity [88] .…”

Section: Family Size/ Sibship/ Birth Ordermentioning

confidence: 59%

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Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

Koloski¹,

Bret²,

Radford‐Smith³

2008

WJG

193

117

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The hygiene hypothesis is thought to be a significant contributor to the growing incidence of inflammatory bowel disease (IBD) around the world, although the evidence for specific factors that underlie the hygiene hypothesis in IBD is unclear. We aimed to systematically review the literature to determine which hygiene-related factors are associated with the development of IBD. Publications identified from a broad based MEDLINE and Current Contents search between 1966 and 2007 on key terms relevant to the 'hygiene hypothesis' and IBD including H pylori exposure, helminths, cold chain hypothesis, measles infection and vaccination, antibiotic use, breastfeeding, family size, sibship, urban upbringing, day care attendance and domestic hygiene were reviewed. The literature suggests that the hygiene hypothesis and its association with decreased microbial exposure in childhood probably plays an important role in the development of IBD, although the strength of the supporting data for each of the factors varies considerably. The most promising factors that may potentially be associated with development of IBD include H pylori exposure, helminths, breastfeeding and sibship. However, the vast majority of studies in this area are plagued by serious methodological shortcomings, particularly the reliance on retrospective recall of information making it difficult to truly ascertain the importance of a 'hygiene hypothesis' in IBD. The 'hygiene hypothesis' in IBD is an important area of research that may give clues to the aetiology of this disease. Directions for future research are recommended.

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Section: Family Size/ Sibship/ Birth Ordermentioning

confidence: 59%

“…Several studies report that a higher incidence of IBD in urban as opposed to rural areas [90,91] . Others however have failed to replicate this finding [16,87] .…”

Section: Urban Upbringingmentioning

confidence: 99%

Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

Koloski¹,

Bret²,

Radford‐Smith³

2008

WJG

193

117

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“…In Crohn's disease, the effect of previous appendectomy remains debated. Some series reported an increased risk of Crohn's disease after appendectomy [5][6][7] , and others did not [8][9][10][11] . These discrepancies may be partly linked to the inclusion or not of appendectomies performed close to the time of diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Prior appendectomy and the phenotype and course of Crohn’s disease

Cosnes

Seksik²,

Nion–Larmurier³

et al. 2006

WJG

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AIM:To determine whether prior appendectomy modifies the phenotype and severity of Crohn's disease. METHODS:Appendectomy status and smoking habits were specified by direct interview in 2838 patients consecutively seen between 1995 and 2004. Occurrence of complications and therapeutic needs were reviewed retrospectively. Additionally, annual disease activity was assessed prospectively between 1995 and 2004 in patients who had not had ileocecal resection and of a matched control group. RESULTS:Compared to 1770 non-appendectomized patients, appendectomized patients more than 5 years before Crohn's disease diagnosis (n =716) were more often females, smokers, with ileal disease. Cox regression showed that prior appendectomy was positively related to the risk of intestinal stricture (adjusted hazard ratio, 1.24; 95% confidence interval, 1.13 to 1.36; P = 0.02) and inversely related to the risk of perianal fistulization (adjusted hazard ratio, 0.75; 95% confidence interval, 0.68 to 0.83; P = 0.002). No difference was observed between the two groups regarding the therapeutic needs, except for an increased risk of surgery in appendectomized patients, attributable to the increased prevalence of ileal disease. Between 1995 and 2004, Crohn's disease was active during 50% of years in appendectomized patients (1 318 out of 2 637 patientyears) and 51% in non-appendectomized patients (1 454 out of 2 841 patient-years; NS). CONCLUSION:Prior appendectomy is associated with a more proximal disease and has an increased risk of stricture and a lesser risk of anal fistulization. However, the severity of the disease is unaffected.

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“…El tabaquismo, tanto el activo como el pasivo, se ha identificado clásicamente como un marcador de mal pronóstico para la EC en general, y está asociado a un mayor número de brotes, de hospitalizaciones, a más probabilidad de precisar tratamientos de segunda línea y a una peor evolución de la enfermedad perianal [1][2][3] . Además, ha sido el único factor epidemiológico identificado como predisponente para la recurrencia posquirúrgica 4 .…”

Section: Factores Epidemiológicos Tabaquismounclassified

Marcadores de evolución de la enfermedad inflamatoria intestinal tratada con inmunomoduladores o agentes biológicos

González-Lama

Vera

Calvo

et al. 2010

Gastroenterología y Hepatología

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Environmental risk factors and Crohn's disease: a population-based, case-control study in Spain

Cited by 33 publications

References 22 publications

Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

Prior appendectomy and the phenotype and course of Crohn’s disease

Marcadores de evolución de la enfermedad inflamatoria intestinal tratada con inmunomoduladores o agentes biológicos

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