Environment plays role in bowel problems

Changing environmental factors seem to play a role in the development of two serious bowel problems like ulcerative colitis and Crohn's disease, known as inflammatory bowel diseases (IBD). Both conditions cause swelling and inflammation of the intestines. Abdominal cramps, weight loss, and bloody diarrhoea are common symptoms. Although drugs are the first-line therapy, surgery may be required for some cases. Researchers at the Medical College of Wisconsin, Milwaukee, USA examined the rate of new cases of IBD occurring in children in Wisconsin over a two-year period. The overall rate of IBD in children was about 7 cases per 100,000 children. The rates of Crohn's disease and ulcerative colitis were about 4.5 and 2.5 cases per 100,000 children, respectively. The average age of diagnosis of Crohn's disease was 13.5 years, and for ulcerative colitis it was 11.8 years. The IBD rates were similar among all ethnic groups, as well as among children from sparsely versus densely populated regions. Only 11 percent of the newly diagnosed IBD cases had close relatives with a history of the disease. The lack of family history and the higher rate of Crohn's disease than ulcerative colitis, suggests that new environmental factors are involved. The incidence of IBD in children they documented in this study is the highest ever reported.

This study provides new, prospective, and comprehensive information on IBD in children. The surprisingly high incidence of paediatric IBD, the predominance of Crohn's disease over ulcerative colitis, the low frequency of patients with a family history, the equal distribution of IBD among all racial and ethnic groups, and the lack of a modulatory effect of urbanisation on IBD incidence, collectively suggest that the clinical spectrum of IBD is still evolving and point to environmental factors contributing to it. A parallel phenomenon is the dramatic increase in asthma during the same period. The concomitant emergence of chronic inflammation in the lung and gut also supports the concept that changing environmental factors play a pivotal role in the increased frequency of these disorders in children.

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