Inflammatory bowel diseases consisting of Crohn's disease and ulcerative colitis are chronic inflammatory diseases of the gastrointestinal tract.
In addition to genetic susceptibility and disturbances of the microbiome, environmental exposures forming the exposome play an important role.
Dr Kimberley van der Sloot and colleagues review the current state of knowledge concerning the exposome.
Starting at birth, the team noted that the cumulative effect of different environmental exposures combined with a predetermined genetic susceptibility is thought to cause inflammatory bowel disease.
|All these environmental factors are part of a Western lifestyle|
|Inflammatory Bowel Diseases|
All these environmental factors are part of a Western lifestyle, suiting the high incidence rates in Europe and the United States.
Whereas receiving breastfeeding, evidence of a Helicobacter pylori infection and vitamin D are important protective factors in Crohn's disease as well as ulcerative colitis, increased hygiene, experiencing a bacterial gastroenteritis in the past, urban living surroundings, air pollution, the use of antibiotics, nonsteroidal anti-inflammatory drugs, and oral contraceptives are likely to be the most important risk factors for both diseases.
The researchers found that current cigarette smoking yields a divergent effect by protecting against ulcerative colitis but increasing risk of Crohn's disease, whereas former smoking increases chances of both diseases.
Dr van der Sloot's team concludes, "Future studies should focus on measuring this exposome yielding the possibility of combining all involved factors to one exposome risk score and our knowledge on genetic susceptibility."