Study On Hygiene Hypothesis And Other Related Factors Of Inflammatory Bowel Disease

Background and Objective Inflammatory bowel disease(IBD) includes ulcerative colitis(UC) and Crohn’s disease(CD).The incidence of IBD is increasing over the past two decades in China, but its etiology and pathogenesis is not yet clear. Many studies, at home and abroad, have found that environmental factors is one of the important reasons for the onset of IBD(such as childhood hygiene, the intake of fruits and vegetables, chili, fat,smoking and the use of antibiotics), and play a role on the pathogenesis of IBD.At home, research about childhood hygiene with the onset of IBD correlation is still rare.Compared with previous studies, this study adds to the survey of infancy hygienic conditions, and explores the possible factors associated with the pathogenesis of UC and CD, such as childhood hygiene, daily diet prior to UC and CD,past medical, medication, operation history and so on.Method A hospital-based case-control study matched 1:1 on gender and age was carried out in Anhui Provincial Hospital. A total of 103 UC cases and 54 CD cases were recruited to fulfill a questionnaire survey. Information on childhood hygiene, breastfeeding, passive smoking, daily diet prior to UC, past medical history and other related factors were collected. Univariate and multivariate analysis were performed to screen the factors related with UC and CD.Results 1.In UC case control study,with univariate analysis, number of siblings in the family, childhood life including contacting animals, drinking raw water, and consumption of unwashed fruits or vegetables, daily dietary factors including consumption of whole grains, sweets and fried food, eating habits, and use of non-steroidal anti-inflammatory drugs(NSAIDs) and antibiotics were significantly different between UC group and control group(P<0.05). Furthermore, multivariate conditional Logistic regression analysis revealed that frequent consumption of friedfood in daily life and frequent use of NSAIDs and antibiotics were risk factors for UC(P<0.05), whereas frequent consumption of unwashed fruits or vegetables in childhood and frequent consumption of whole grains in daily life were protective factors for UC(P<0.05).2.In CD case control study,with univariate analysis, education degree, childhood life including contacting animals and farmland, and sharing with family toiletries, daily dietary factors including consumption of vegetables, and use of non-steroidal anti-inflammatory drugs(NSAIDs) and antibiotics were significantly different between CD group and control group(P<0.05). Furthermore, multivariate conditional Logistic regression analysis revealed that education degree and frequent use of antibiotics were risk factors for CD(P<0.05), whereas frequent consumption of vegetables in daily life were protective factors for CD(P<0.05).Conclusion Highly hygienic living conditions in childhood may increase the risk of UC and CD. Fewer fried food, suitable whole grains and fair use of NSAIDs and antibiotics might protect against the occurrence of UC,suitable vegetables and fair use of antibiotics might protect against the occurrence of CD.