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| {{CMG}} | | {{CMG}} |
| ==Overview== | | ==Overview== |
| | Common [[risk factors]] in the development of crohns disease include white ancestry, age 15-40 or 60-80 years, family history of crohns disease and [[cigarette smoking]]. |
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| ==Risk Factors== | | ==Risk Factors== |
| Although the cause of Crohn's disease is not known, it is believed to be an [[autoimmunity|autoimmune disease]] that is [[genetics|genetically]] linked. The highest relative risk occurs in siblings, affecting males and females equally. Smokers are three times more likely to get Crohn's disease.
| | Common risk factors in the development of crohns disease include <ref>{{cite journal | author = Cosnes J | title = Tobacco and IBD: relevance in the understanding of disease mechanisms and clinical practice. | journal = Best Pract Res Clin Gastroenterol | volume = 18 | issue = 3 | pages = 481-96 | year = 2004 | id = PMID 15157822}}</ref><ref>{{cite journal|last=Morris|first= Danielle L|date=2000-11-18|title=Early environmental factors may have role in both Crohn's disease and gastric carcinoma - Letter to the Editor|journal=British Medical Journal|url=http://findarticles.com/p/articles/mi_m0999/is_7271_321/ai_67708495/|accessdate=2008-01-16}}</ref><ref><!-- |
| | | ** -->{{cite journal | author = Lesko S, Kaufman D, Rosenberg L, ''et al.'' | title = Evidence for an increased risk of Crohn's disease in oral contraceptive users. | journal = Gastroenterology | volume = 89 | issue = 5 | pages = 1046-9 | year = 1985 | id = PMID 4043662}}</ref> |
| Unlike the other major type of IBD, [[ulcerative colitis]], there is no known medical or [[surgery|surgical]] cure for Crohn's disease.<ref>{{cite web|first= M Bashar|last= Al-Ataie|coauthors=Vishwanath N Shenoy|publisher=eMedicine|title=Ulcerative colitis|url=http://www.emedicine.com/med/topic2336.htm|accessdate=2006-07-02|
| | *White ancestry |
| date=2005-10-04}}</ref> Instead, a number of medical treatments are utilized with the goal of putting and keeping the disease in [[remission (medicine)|remission]]. These include [[mesalazine|5-aminosalicylic acid]] (5-ASA) formulations (Pentasa capsules, Asacol tablets, Lialda tablets, Rowasa retention enemas), [[prednisone|steroid]] medications, immunomodulators (such as [[azathioprine]], [[mercaptopurine]] (6-MP), and [[methotrexate]]), and newer [[biological therapy for inflammatory bowel disease|biological]] medications, such as [[infliximab]] (Remicade) and [[adalimumab]] (Humira).<ref name=Podolsky>{{Cite journal|last=Podolsky|first= Daniel K.|title=Inflammatory bowel disease|journal=New England Journal of Medicine|month=August|year=2002|volume=346|issue=6|pages=417-29
| | *Age 15-40 or 60-80 years |
| |url=http://content.nejm.org/cgi/content/extract/347/6/417|accessdate=2006-07-02|id=PMID 12167685}}</ref>Also in January 2008 the U.S. Food and Drug Administration approved a new biologic known as [[natalizumab]] (Tysabri) for both induction of remission and maintenance of remission in moderate and severe Crohns Disease. | | *Family history of CD |
| | | *[[Cigarette smoking]], smokers are three times more likely to get Crohn's disease. |
| Ethnic background is also a risk factor. Until very recently, whites and European Jews accounted for the vast majority of the cases in the United States, and in most industrialized countries, this demographic is still true.
| | *Diet rich in sugars |
| | | *[[Oral contraceptives]] |
| Many environmental factors have also been hypothesized as causes or risk factors for Crohn's disease. Proven environmental risk factors include living in an industrialized country, smoking, and living in an urban area. Diets high in sweet, [[fat]]ty or [[Food processing|refined foods]] may also play a role. A retrospective Japanese study found that those diagnosed with Crohn's disease had higher intakes of sugar, fat, fish and shellfish than controls prior to diagnosis.<!--
| | *[[NSAIDS]] |
| --><ref>{{cite journal | author = Sakamoto N, Kono S, Wakai K, ''et al.'' | title = Dietary risk factors for inflammatory bowel disease: a multicenter case-control study in Japan. | journal = Inflamm Bowel Dis | volume = 11 | issue = 2 | pages = 154-63 | year = 2005 | id = PMID 15677909}}</ref> A similar study in Israel also found higher intakes of fats (especially chemically modified fats) and [[sucrose]], with lower intakes of [[fructose]] and fruits, water, [[potassium]], [[magnesium]] and vitamin C in the diets of Crohn's disease sufferers before diagnosis,<!-- | | *Living in an industrialized country |
| --><ref>{{cite journal | author = Reif S, Klein I, Lubin F, Farbstein M, Hallak A, Gilat T | title = Pre-illness dietary factors in inflammatory bowel disease. | journal = Gut | volume = 40 | issue = 6 | pages = 754-60 | year = 1997 | id = PMID 9245929| url = http://gut.bmj.com/cgi/reprint/40/6/754 | format = PDF }}</ref> and cites three large European studies in which sugar intake was significantly increased in people with Crohn's disease compared with controls. Certain chemicals in the diet, known as microparticles, are also hypothesized as a risk factor for the disease, as well as a poor imbalance of omega-6 to healthy omega-3 fatty acids that emerging research shows helps to improve all types of inflammatory disease. The most common forms of microparticles include titanium dioxide, aluminosilicates, anatase, calcium phosphate, and soil residue. These substances are ubiquitous in processed food and most toothpastes and lip glosses. Soil residue is found on fresh fruits and vegetables unless carefully removed.
| | *Certain chemicals in the diet, known as microparticles, are also hypothesized as a risk factor for the disease, as well as a poor imbalance of omega-6 to healthy [[omega-3 fatty acids]] that emerging research shows helps to improve all types of inflammatory disease. |
| | | *[[Gastric cancer]] is most often caused by the bacterium [[Helicobacter pylori]] that flourishes in cramped and unsanitary conditions. |
| [[Tobacco smoking|Smoking]] has been shown to increase the risk of the return of active disease, or "flares".<ref>{{cite journal | author = Cosnes J | title = Tobacco and IBD: relevance in the understanding of disease mechanisms and clinical practice. | journal = Best Pract Res Clin Gastroenterol | volume = 18 | issue = 3 | pages = 481-96 | year = 2004 | id = PMID 15157822}}</ref> | |
| The introduction of [[hormonal contraception]] in the United States in the 1960's is linked with a dramatic increase in the incidence rate of Crohn's disease. Although a causal linkage has not been effectively shown, there remain fears that these drugs work on the digestive system in similar ways to smoking.<ref><!--
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| -->{{cite journal | author = Lesko S, Kaufman D, Rosenberg L, ''et al.'' | title = Evidence for an increased risk of Crohn's disease in oral contraceptive users. | journal = Gastroenterology | volume = 89 | issue = 5 | pages = 1046-9 | year = 1985 | id = PMID 4043662}}</ref>
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| Additionally, many in the scientific community believe that early childhood exposure to illness is necessary to the creation of a proper immune system for those with the genetic suseptibility for Crohn's Disease. Like Polio, higher incidences of Crohn's Disease are associated with cleaner living conditions. Throughout the early and mid-20th century in the United States, the disease was strongly associated with upper-class populations, and today the disease does not yet exist in the many Third World countries, despite the fact that it occurs in all races. CD is also associated with first born and single children (because they would have less exposure to childhood illness from siblings) and in populations that have low incidences of gastric cancer. Gastric cancer is most often caused by the bacterium Helicobacter pylori that flourishes in cramped and unsanitary conditions.<ref>{{cite journal|last=Morris|first= Danielle L|coauthors=Scott M Montgomery|date=2000-11-18|title=Early environmental factors may have role in both Crohn's disease and gastric carcinoma - Letter to the Editor|journal=British Medical Journal|url=http://findarticles.com/p/articles/mi_m0999/is_7271_321/ai_67708495/|accessdate=2008-01-16}}</ref>
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| ==References== | | ==References== |
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| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |
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| | [[Category:Needs overview]] |
| | [[Category:Disease]] |
| | [[Category:Autoimmune diseases]] |
| | [[Category:Digestive diseases]] |
| | [[Category:Gastroenterology]] |
| | [[Category:Genetic disorders]] |
| | [[Category:Inflammations]] |
| | [[Category:Conditions diagnosed by stool test]] |
| | [[Category:Abdominal pain]] |