Case-control study of factors that trigger inflammatory bowel disease flares

Area of Science:

• Gastroenterology
• Immunology
• Clinical Medicine

Background:

• Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are chronic conditions characterized by recurrent flares.
• Identifying triggers for IBD flares is crucial for effective disease management and improving patient quality of life.

Purpose of the Study:

• To investigate potential triggers associated with acute flares in patients with inflammatory bowel diseases.
• To determine the relationship between various factors and the occurrence of IBD flares.

Main Methods:

• A cohort of 134 patients with IBD (63 Crohn's disease, 70 ulcerative colitis) were enrolled, including 66 in flare and 68 in remission.
• Participants were systematically queried about potential triggers such as NSAID use, antibiotics, stress, smoking, medication adherence, infections, and travel.
• Multivariate regression analysis was employed to identify significant associations between triggers and IBD flares, with disease activity scores calculated.

Main Results:

• Medication non-adherence was significantly more frequent in patients experiencing IBD flares compared to controls (48.5% vs 29.4%, P = 0.03).
• Non-adherence remained a significant predictor of flares on multivariate analysis (OR = 2.86).
• Conversely, the use of immunomodulators was associated with a significantly lower rate of IBD flares (OR = 0.40).

Conclusions:

• Medication non-adherence emerged as a significant and independent risk factor for inflammatory bowel disease flares.
• These findings underscore the importance of improving medication adherence strategies in managing IBD.
• Immunomodulator therapy may play a protective role in preventing IBD flares.