• Inflammatory bowel disease is a chronic condition that can cause many unpleasant symptoms and damage the digestive tract.
• Researchers and medical professionals are still working to understand the best ways to treat people who experience inflammatory bowel disease.
• A​ recent study found that adherence to specific lifestyle factors may successfully prevent many inflammatory bowel disease cases.

Inflammatory bowel disease (IBD) is a chronic condition that can require lifelong management. Treatment can focus on the prevention and control of symptoms. Researchers are still working to understand how people can prevent IBD.

A​ study published in the BMJ journal Gut found that adherence to certain lifestyle factors may effectively prevent many inflammatory bowel disease cases.

Impact of inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic condition that causes inflammation and damage to the gastrointestinal tract. People with IBD can experience various symptoms, including abdominal pain, diarrhea that is sometimes bloody, nausea, and vomiting. Someone’s symptoms will depend on IBD severity and the type of IBD.

N​on-study author Dr. Ioannis Economou, Gastroenterologist and Associate Professor of Medicine at Columbia University Irving Medical Center, explained to Medical News Today:

“Inflammatory bowel disease affects more than 3 million people in the US. It consists of two diseases, Crohn’s disease, and Ulcerative Colitis, which demonstrate many similarities but also significant differences. They are chronic diseases with no known cure and significant impact in the quality of life of the affected individuals. Patients are diagnosed at the most productive years of their life, with many of them being diagnosed in their childhood. They might have no symptoms when their disease is under control, but can develop multiple intestinal and extraintestinal manifestations during periods of flare.”

T​he exact cause of IBD is unknown, but researchers are continuing to study how lifestyle factors may play a role in IBD development and prevention.

IBD prevention and lifestyle factors

T​his particular study was a prospective cohort study. Researchers wanted to see whether IBD could be prevented by modifying certain lifestyle factors. They created modifiable risk scores (MRS) for participants based on their adherence to these lifestyle factors.

F​or example, they looked at factors like smoking, body mass index (BMI), nonsteroidal anti-inflammatory drug (NSAID) use, and physical activity levels. They also looked at dietary factors like red meat, fruit and vegetable, and fiber intake. The specific factors included were dependent on the type of IBD.

T​hey also gave participants healthy lifestyle scores based on participants’ adherence to a healthy lifestyle. Researchers defined a healthy lifestyle based on recommendations from the U.S. Department of Health and Human Services (HHS), the U.S. Department of Agriculture (USDA) Dietary Guidelines for Americans, and the American Heart Association (AHA) Guidelines for Healthy Living.

Their analysis showed that low modifiable risk scores could prevent almost 43% of Crohn’s disease cases and over 44% of ulcerative colitis cases. They further estimated that following a healthy lifestyle could prevent about 61% of Crohn’s disease cases and about 42% of ulcerative colitis cases.

“Study author Dr. Emily W. Lopes, M.P.H explained to MNT:

“In six large cohorts of US and European adults, adherence to a number of dietary and lifestyle factors known to be associated with risk of Crohn’s disease (CD) and ulcerative colitis (UC) could have prevented a substantial number of cases. Adherence to a healthy diet and lifestyle also could have prevented a substantial number of CD and UC cases. It is important to note that a key assumption underlying our analysis is that a direct causal relationship exists between lifestyle and dietary factors and risk of CD and UC.”

Study limitations and continued research

The study did have some limitations. First, their cohort’s average age of diagnosis with IBD was older than when IBD typically manifests. Thus, lifestyle modifications may not be as effective in preventing earlier onset cases of IBD, where genetics may be more heavily involved.

D​r. Economou noted:

“A prospective study with initiation in early childhood, including a diverse population from multiple countries, especially of high-risk individuals with positive family history, and potential interventions, can assist further in delineating the effect of lifestyle and modifiable risk factors.”

Researchers also did not look at other factors that could have played a role in IBD development, like pollution and socioeconomic status, because these factors could not easily be modified. They also didn’t have data on other potentially influential factors like stress. Based on the factors they couldn’t include, there is the risk of confounding.

Based on the sample, further research could include more participants from non-Western countries and more participants. More information is also needed to help determine a true causal relationship between these lifestyle factors and IBD.

D​r. Lopes explained to MNT:

“If our findings are true, this suggests that choosing “low-risk” or healthy dietary and lifestyle habits may be an effective strategy to prevent CD and UC. It is essential that future studies, such as causal analyses and randomized trials, be conducted to confirm our findings and explore the effectiveness of this strategy for prevention of CD and UC in high-risk populations.”

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