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Geographical variability and environmental risk factors in inflammatory bowel disease
Li Ka Shing Inst Hlth Sci, Dept Med & Therapeut, Inst Digest Dis, Chinese Univ, Hong Kong, China.
Dept Internal Med, IBD Clin & Res Ctr, University Manitoba, Winnipeg MB, Canada.
Dept Gastroenterol, Inst Clin Med, EpiGen, University of Oslo, Oslo, Norway.
Dept Med 1, Semmelweis University, Budapest, Hungary.ORCID iD: 0000-0002-3948-6488
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2013 (English)In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 62, no 4, p. 630-649Article in journal (Refereed) Published
Abstract [en]

The changing epidemiology of inflammatory bowel disease (IBD) across time and geography suggests that environmental factors play a major role in modifying disease expression. Disease emergence in developing nations suggests that epidemiological evolution is related to westernisation of lifestyle and industrialisation. The strongest environmental associations identified are cigarette smoking and appendectomy, although neither alone explains the variation in incidence of IBD worldwide. Urbanisation of societies, associated with changes in diet, antibiotic use, hygiene status, microbial exposures and pollution have been implicated as potential environmental risk factors for IBD. Changes in socioeconomic status might occur differently in different geographical areas and populations and, consequently, it is important to consider the heterogeneity of risk factors applicable to the individual patient. Environmental risk factors of individual, familial, community-based, country-based and regionally based origin may all contribute to the pathogenesis of IBD. The geographical variation of IBD provides clues for researchers to investigate possible environmental aetiological factors. The present review aims to provide an update of the literature exploring geographical variability in IBD and to explore the environmental risk factors that may account for this variability.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2013. Vol. 62, no 4, p. 630-649
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-55019DOI: 10.1136/gutjnl-2012-303661ISI: 000315595800019PubMedID: 23335431Scopus ID: 2-s2.0-84874652518OAI: oai:DiVA.org:oru-55019DiVA, id: diva2:1069277
Available from: 2017-01-27 Created: 2017-01-27 Last updated: 2018-08-28Bibliographically approved

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