Crohn's disease (CD) and ulcerative colitis (UC) are two pathotypes of inflammatory bowel disease (IBD) with unique pathology, risk factors and significant morbidity.
Dr Porter and colleagues from Maryland, USA estimated incidence, and identified IBD risk factors in a US military population, a healthy subset of the US population, using information from the Millennium Cohort Study.
Incident IBD was identified from medical encounters from 2001 to 2009 or by self-report.
The team's primary risk factor of interest, infectious gastroenteritis, was identified from medical encounters and self-reported post-deployment health assessments.
Other potential risk factors were assessed using self-reported survey responses and military personnel files.
|Antecedent infectious gastroenteritis was associated with almost a 3-fold increase in UC risk|
|Alimentary Pharmacology & Therapeutics|
The team estimated 23 and 22 diagnoses per 100,000 person-years, respectively, for CD and UC.
For CD, the researchers observed significant risk factors including current smoking, 2 life stressors, and prior irritable bowel syndrome.
The research team found no significant association with prior infectious gastroenteritis.
There was an apparent dose–response relationship between UC risk, and an increasing number of life stressors.
In addition, the research team noted that antecedent infectious gastroenteritis was associated with almost a 3-fold increase in UC risk.
Moderate alcohol consumption was associated with lower UC risk.
Dr Porter's team concludes, "Stressful conditions and the high risk of infectious gastroenteritis in deployment operations may play a role in the development of IBD in military populations."
"However, observed differences in risk factors for UC and CD warrant further investigation."