Related Experiment Video
Updated: Oct 13, 2025
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Environmental risk factors for inflammatory bowel disease: A case control study in Southeast Asian children
Way S Lee1,2, Zhi L Song3, Sean Y Wong3
1Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
Insights
Early childhood infections and antibiotic use are linked to pediatric inflammatory bowel disease (IBD) in Southeast Asia. Breastfeeding and rotavirus vaccination may protect against IBD.
Area of Science:
- Pediatric Gastroenterology
- Environmental Health
- Epidemiology
Background:
- Early-life environmental exposures significantly influence inflammatory bowel disease (IBD) pathogenesis.
- Understanding these factors in Asian children is crucial for IBD etiology and prevention.
Purpose of the Study:
- To investigate environmental risk and protective factors preceding the onset of childhood IBD in a Southeast Asian population.
- To identify key environmental exposures associated with pediatric IBD, Crohn's disease (CD), and ulcerative colitis (UC).
Main Methods:
- A case-control study involving children diagnosed with IBD before age 18 and matched controls.
- Data collected via questionnaires on medical, family, dietary, social, home environment, childhood illnesses, and immunization histories.
Main Results:
- Childhood acute gastroenteritis and excessive early antibiotic use were significant risk factors for IBD, CD, and UC.
- Risk factors included aquariums, stressful life events, and concurrent schooling with siblings; protective factors included prolonged breastfeeding and safe water consumption.
- Rotavirus vaccination was associated with reduced odds of developing IBD.
Conclusions:
- Identified several environmental risk and protective factors for IBD in Southeast Asian children.
- Findings offer insights into IBD etiology and inform future prevention strategies for pediatric IBD in the region.
Aim:
Early-life environmental exposure, which has important implications in the pathogenesis of inflammatory bowel disease (IBD), is not well understood in Asian children. We examined environmental factors prior to the development of childhood IBD in a Southeast Asian population.
Methods:
We conducted a case control study in IBD diagnosed before 18 years of age and controls matched by gender, age and ethnicity. A questionnaire recording medical, family, dietary and social histories, home environment, childhood diseases and immunisation status was used.
Results:
In a multivariate analysis involving 70 children with IBD (Crohn's disease (CD) = 38; ulcerative colitis (UC) = 32) and 140 controls, childhood acute gastroenteritis (odds ratio (OR): IBD 6.9; CD 7.8; UC 5.8) and excessive antibiotic usage in early childhood (OR: IBD 5.3; CD 4.2; UC 4.8) were significantly associated with IBD, CD and UC. Having a fish or turtle aquarium (OR 6.0), major stressful life events (OR 5.6) and attending the same school concurrently with a sibling (OR 2.9) were significant risk factors for IBD. Duration of breastfeeding >6 months (OR: IBD 0.4; UC 0.2) and safe water consumption (OR: IBD 0.2; UC 0.2) reduced the odds of having IBD and UC, respectively. Being vaccinated for rotavirus reduced the odds of developing IBD (OR 0.1).
Conclusions:
Several risk and protective factors were identified in this environmental risk study in Southeast Asian children with IBD. This knowledge has important implications in understanding disease aetiology and future prevention strategies to reduce the development of IBD in Southeast Asian children.
More Related Videos
Related Concept Videos
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:17Irritable Bowel Syndrome I: Introduction
IBS is a chronic condition that can persist over a long period or recur frequently.
The pathogenesis of IBS involves a complex interplay of the following factors:
Altered...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:23Anatomy of the Intestines
Small Intestines
The small intestine is an ~7 meter-long tube with an inner diameter of just 2.5 cm. Since most nutrients are absorbed here, the inner lining of the...