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Identification of early environmental risk factors for irritable bowel syndrome and dyspepsia
N A Koloski1, M Jones2, M Weltman3
1Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
Insights
Childhood environments, like sharing bedrooms and having pets, are linked to developing irritable bowel syndrome (IBS) later in life. These early life microbial exposures may increase the risk of IBS and functional dyspepsia.
Area of Science:
- Gastroenterology
- Epidemiology
- Environmental Health
Background:
- The influence of early childhood environmental exposures on the development of gastrointestinal disorders like irritable bowel syndrome (IBS) and functional dyspepsia remains largely unexplored.
- Investigating early life microbial exposures may provide insights into the etiology of these common conditions.
Purpose of the Study:
- To examine the association between proxy measures of microbial exposure in early childhood and the subsequent development of IBS and functional dyspepsia in adulthood.
- To identify specific childhood environmental factors that may predispose individuals to these gastrointestinal conditions.
Main Methods:
- A random population sample of 767 adults from Sydney, Australia, who had previously completed a survey, were assessed using Rome III criteria for IBS and functional dyspepsia.
- Early environmental risk factors evaluated included birth delivery type, premature birth, breastfeeding duration, bedroom sharing, and pet exposure up to age five.
- Post-infectious IBS (PI-IBS) was defined as IBS developing after a gastroenteritis episode.
Main Results:
- In adulthood, 17% of participants developed IBS (20% of whom had PI-IBS) and 12% developed functional dyspepsia.
- Childhood factors associated with IBS development included shorter breastfeeding duration, bedroom sharing, exposure to herbivore pets, and combined early hygiene factors.
- Exposure to a herbivore pet was the only childhood factor significantly associated with functional dyspepsia.
Conclusions:
- Childhood environmental factors, specifically bedroom sharing and pet exposure, alongside microbial exposure risks, are associated with an increased risk of developing IBS later in life.
- These findings suggest a potential link between early environmental exposures and adult gastrointestinal health.
- Further research is warranted to confirm these associations and mitigate the risk of type I errors.
Background:
The role of childhood environment including exposure to infection via siblings and pets in irritable bowel syndrome (IBS) and dyspepsia is relatively unknown. We assessed proxy measures of microbial exposure in early childhood to assess if these are associated with IBS and functional dyspepsia in later life.
Methods:
Participants (n = 767, response rate = 53%) were a random population sample from Sydney, Australia who previously responded to a validated survey. IBS and functional dyspepsia were defined using Rome III criteria. Early environmental risk factors assessed included type of birth delivery, premature birth, breastfeeding, bedroom sharing, and pet exposure (the latter two then combined as early hygiene factors) up to 5 years of age. Post infectious IBS (PI-IBS) was assessed by development of IBS following gastroenteritis.
Key Results:
In this sample, in adult life 17% developed IBS (of which 20% had PI-IBS) and 12% functional dyspepsia. Development of IBS was associated with childhood factors-a shorter duration of breastfeeding (odds ratios [OR] = 0.87, 95% CI: 0.78-0.97, p = 0.01), sharing a bedroom (OR = 1.89, 95% CI: 1.73-3.08, p = 0.01), exposure to a herbivore pet (OR = 1.65 (1.10, 2.48), p = 0.02), and hygiene factors (OR = 4.39; 95% CI: 1.89-10.21, p = 0.001). The sole factor associated with functional dyspepsia was exposure to a herbivore pet (1.79; 95% CI: 1.19-2.87, p = 0.02).
Conclusions & Inferences:
Childhood environment factors, particularly bedroom sharing and pet exposure, combined with subsequent risk of microbial exposure are a risk factor for IBS in later life. These associations however need confirmation to rule out any risk of a type I error.
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