THE ROLE OF ALCOHOL USE IN THE DEVELOPMENT OF CROHN’S DISEASE COMPLICATIONS: A RETROSPECTIVE ANALYSIS

Abstract

Abstract BACKGROUND Crohn’s disease (CD) is a type of inflammatory bowel disease (IBD) characterized by transmural inflammation that can occur anywhere along the gastrointestinal (GI) tract. Complications of CD include fistulization, abscess formation, and GI bleed. Many social and environmental factors have been associated with CD. The role of alcohol use remains unclear, with some studies suggesting that it may increase the risk of CD and worsen symptoms, and others showing no relationship between alcohol and CD. We aimed to assess the association between alcohol use and the development of CD complications using a large nationwide database. METHODS Patients with a diagnosis of CD were identified using the 2020 Nationwide Inpatient Sample (NIS). Patients were stratified based on whether they had a history of alcohol use. Outcomes included development of fistula, abscess, or bleed. Data were also collected regarding age, gender, race, primary insurance, median income, hospital region, hospital bed size, and comorbidities. The relationship between alcohol use and the development of fistula, abscess, or bleed among patients hospitalized with CD was analyzed using multivariate regression analysis. RESULTS A total of 178,279 patients with a diagnosis of CD were included in the study. Of these, 7,131 (4.0%) had a history of alcohol use. Patients in the alcohol group had lower odds of developing fistula (aOR 0.51, P < 0.001) and abscess (aOR 0.42, P < 0.001). There was no difference in the development of bleed in CD patients with alcohol use compared to without. Patients in the alcohol group had overall lower odds of developing any complication of CD (aOR 0.60, P < 0.001). CONCLUSION CD is a chronic and complex inflammatory disease that can lead to a variety of GI complications including fistula formation, abscess, and bleeding. Many genetic, environmental, social, and immune factors play a role in the disease course. Our study found that alcohol use is associated with a decreased risk of developing CD-related fistula or abscess. Patients with a history of alcohol use have been shown to exhibit earlier and more severe GI symptoms in CD, possibly leading to earlier presentation. Additionally, alcohol use has been found to suppress the immune response, potentially explaining our findings. Further studies are needed to assess the role of alcohol in the pathogenesis and disease course of CD. Inclusion process for the study.