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.
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.
Authors: Leslie M Higuchi; Hamed Khalili; Andrew T Chan; James M Richter; Athos Bousvaros; Charles S Fuchs Journal: Am J Gastroenterol Date: 2012-07-10 Impact factor: 10.864
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Authors: Hamed Khalili; Leslie M Higuchi; Ashwin N Ananthakrishnan; James M Richter; Diane Feskanich; Charles S Fuchs; Andrew T Chan Journal: Gut Date: 2012-05-22 Impact factor: 23.059
Authors: J M Otto; A F O'Doherty; P J Hennis; K Mitchell; J S Pate; J A Cooper; M P W Grocott; H E Montgomery Journal: Int J Colorectal Dis Date: 2012-07-29 Impact factor: 2.571
Authors: Hamed Khalili; Leslie M Higuchi; Ashwin N Ananthakrishnan; JoAnn E Manson; Diane Feskanich; James M Richter; Charles S Fuchs; Andrew T Chan Journal: Gastroenterology Date: 2012-07-27 Impact factor: 22.682