Gut 2008;57:1185-1191
Leader
Disorders of a modern lifestyle: reconciling the epidemiology of inflammatory bowel diseases
1 University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, Winnipeg, Manitoba, Canada
2 Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland
Dr Charles N Bernstein, 804F-715 McDermot Avenue, University of Manitoba, Winnipeg, Manitoba, Canada R3E 3P4; cbernst@cc.umanitoba.ca
Revised version received 5 May 2008
Accepted 7 May 2008
| The first 150 words of the full text of this article appear below. |
Few would contest that advances in uncovering genetic risk factors for Crohn’s disease and ulcerative colitis over the past decade have changed the way we think about inflammatory bowel diseases (IBDs). Perhaps the most important message has been that much of the genetically determined risk lies in how the host interprets its microbial environment.1–3 However, the primacy of environmental factors was already evident from several sources; notably, studies of genetically identical twins showing a relatively low concordance rate for both Crohn’s disease (<50%) and ulcerative colitis (<10%), and the increased frequency of both disorders in many countries during a period too short to involve significant changes in the population gene pool.4 What are the environmental or lifestyle risk factors for IBD? How do they collude with genetic susceptibility?
The lesson of Helicobacter pylori and peptic ulcer disease was that the solution to some chronic disorders cannot be found by studying
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