The factors of risk and protection at inflammatory bowel diseases

Abstract

By to date the investigations have been performed for 71 factors of risk or prevention of the development of inflammatory bowel disease (IBD), non‑specific ulcerative colitis (UC) and Crohn’s disease (CD), including lifestyle and hygiene conditions, surgical operations, exposure to drugs, diets and nutrients, microorganisms and vaccines. Among them, nine risk factors and seven protective factors have been revealed that have a moderate and high level of evidence and 11 risk factors and 16 protective factors with weak evidence level. Nine risk factors that with moderate or high level of evidence include smoking (CD), city living (CD/IBD), appendectomy (CD), tonsillectomy (CD), antibiotic treatment (IBD), oral contraceptives (IBD), non‑alcoholic beverages (UC), vitamin D deficiency (IBD), enterohepatic strains of Helicobacter bacteria (IBD). Accordingly, the same relationship was demonstrated by 7 protective factors: physical activity (CD), breastfeeding (IBD), shared bed (CD), tea consumption (UC), high levels of folic acid (IBC), high levels of vitamin D (BC), H. pylori infection (CD/UC/IBD).Although the possible mechanistic foundations of these associations are still not entirely clear, there is a corresponding biological explanation for several factors. An analysis of the above factors of risk and prevention of IBD opens up certain prospects for the prophylaxis of these diseases. For example, given the moderate and pronounced protective effects of physical activity and tea consumption, it is advisable to recommend these interventions for the IBD prevention, especially in individuals with a family history of IBD. However, further additional well‑planned, high‑quality epidemiological studies are needed with respect to many of these factors, including clarification of dose‑dependent effects and studies of different populations. Such studies will help to better understand the role of various risk factors and protection in IBD, as well as develop new methods of prevention, which so far leave much to be desired.