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Role of Environmental Risk Factors in the Etiology of Inflammatory Bowel Diseases: A Multicenter Study

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Abstract

Background

The increasing global incidence and prevalence of inflammatory bowel disease (IBD) necessitates an investigation into the potential influence of environmental risk factors on its origin.

Aim

This multicenter case-control study aimed to investigate potential environmental risk factors contributing to IBD development in Turkey.

Methods

The study included 156 Crohn’s disease (CD), 277 ulcerative colitis (UC) patients, and 468 controls (matched for age and gender) from six hospitals’ gastroenterology departments. Data collection relied on the International Organization of IBD’s questionnaire on environmental factors. Each environmental factor was initially analyzed using univariate and subsequently multivariate logistic regression models.

Results

In the multivariate model, regular coffee consumption was associated with decreased odds for both CD (OR 0.28; 95% CI 0.14–0.55) and UC (OR 0.25; 95% CI 0.15–0.42). Stress was associated with UC (OR 3.27; 95% CI 1.76–6.10) and CD (OR 4.40; 95% CI 2.12–9.10) development. A history of childhood infectious diseases (gastroenteritis, upper respiratory tract infections, etc.) raised the odds for both CD (OR 9.45; 95% CI 2.51–35.6) and UC (OR 7.56; 95% CI 1.57–36.4). Conversely, consuming well/spring water (OR 0.22; 95% CI 0.10–0.50) and childhood antibiotic use (OR 0.41; 95% CI 0.18–0.93) showed a positive association against UC. Increased consumption of refined sugar and industrial food products emerged as risk factors for IBD. Smoking increased the risk for CD (OR 2.38; 95% CI 1.16–4.91), while ex-smoking increased the risk for UC (OR 3.16; 95% CI 1.19–8.37).

Conclusions

This study represents the first multicenter case–control study in Turkey examining the effects of environmental factors on IBD. It revealed that coffee consumption is positively associated, while stress and childhood infection-related diseases are risk factors. These findings, which are not supported by other studies, provide insight into the relationships between these factors and IBD.

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Acknowledgments

We extend our heartfelt thanks to everyone who contributed to the implementation and completion of the questionnaires, which are the most crucial factor for this article.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey

    Cemile Cansu Alperen

  2. Department of Gastroenterology, Baskent University Adana Medical and Research Center, Adana, Turkey

    Barıs Soydas & Ender Serin

  3. Department of Gastroenterology, Baskent University Alanya Medical and Research Center, Alanya, Turkey

    Mustafa Erbayrak

  4. Department of Gastroenterology, Baskent University Istanbul Hospital, Istanbul, Turkey

    Nurten Akyurek Savas

  5. Department of Gastroenterology, Baskent University Konya Medical and Research Center, Konya, Turkey

    Gulhan Kanat Unler

  6. Department of Gastroenterology, Baskent University Izmir Medical and Research Center, Izmir, Turkey

    Cenk Emre Meral

  7. Department of Biostatistics, Faculty of Medicine, Baskent University, Ankara, Turkey

    Ugur Toprak

  8. Department of Gastroenterology, Faculty of Medicine, Baskent University, Ankara, Turkey

    Ahmet Sedat Boyacioglu & Ulku Dagli

Authors
  1. Cemile Cansu Alperen
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Contributions

Study concept and design: C. Cansu Alperen and Ulku Dagli. Data acquisition: C. Cansu Alperen. Contribution to patient sharing and data collection process: Baris Soydas, Ender Serin, Mustafa Erbayrak, Nurten A. Savas, Gulhan K. Unler, Cenk Emre Meral, Ahmet Sedat Boyacioglu. Data analysis: Ugur Toprak, C. Cansu Alperen. Interpretation of data: C. Cansu Alperen, Ugur Toprak, Ulku Dagli. Drafting of the manuscript: C. Cansu Alperen. Critical revision and approval: Ulku Dagli and C. Cansu Alperen.

Corresponding author

Correspondence to Cemile Cansu Alperen.

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The authors declare that they have no confict of interest.

Ethical approval

Ethical approval from Başkent University Faculty of Medicine Research and Ethics Committee (Project No. KA20/306) validated the research’s scientific and ethical basis.

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Alperen, C.C., Soydas, B., Serin, E. et al. Role of Environmental Risk Factors in the Etiology of Inflammatory Bowel Diseases: A Multicenter Study. Dig Dis Sci (2024). https://doi.org/10.1007/s10620-024-08491-w

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