Introduction Genetic predisposition, does not account solely for disease aetiology. Other environmental and childhood factors might explain the rise of inflammatory bowel disease (IBD) in recent years.
Methods All patients diagnosed with IBD between 2012 and 2014 at Mater Dei Hospital in Malta were included in this study. Each patient was then asked to fill in a questionnaire related to childhood factors.
Results 152 patients (mean age 42.4 years sd±17.7; mean age at diagnosis 39.8 years sd±17.7) were included in this study. 55.9% were male. 65.8% patients suffered from UC.
Association between Montreal classification and childhood factors: If patients were brought up with siblings, they were more likely to have an older Montreal age at diagnosis (p < 0.018). The age at which patients were separated at school from their siblings was statistically related to Montreal behaviour (p < 0.018). Patients who swam in a pool had a younger Montreal age at diagnosis (p < 0.028).
Association of type of IBD with childhood factors: When factors were assessed individually, more patients with UC than CD shared a bedroom with their siblings (p < 0.003). On binary logistic regression analysis, having contracted measles (p < 0.033) and mumps (p < 0.021) were statistically significant in determining type of IBD our patients had.
Association of childhood factors with age at diagnosis: Factors leading to an older age at diagnosis of IBD: whether patients were brought up with siblings (p < 0.001), underwent cholecystectomy (p < 0.002), contracted measles (p < 0.001) during childhood. Factors leading to a younger age at diagnosis of IBD: whether they were vaccinated (p < 0.029), if they owned fish (p < 0.004), whether they went swimming (p < 0.012), if they swam in a pool (p < 0.001), most swimming modalities (p < 0.001). Only the factors below retained statistical significance when assessed using univariate regression analysis. Sharing a bedroom with siblings(p < 0.0001) and having undergone a tonsillectomy (p < 0.019) predisposed to an older age at diagnosis. Sharing day nursery with siblings (p < 0.002), swimming in the sea (p < 0.019) and in a pool (p < 0.007) all predisposed to a younger age at diagnosis of IBD.
Conclusion Certain factors such as vaccination and swimming at a young age might predispose to a younger age at diagnosis of IBD. Other factors such as being brought up with siblings were protective and lead to an older age at diagnosis. Studying such factors on a bigger scale might further confirm these trends and may influence lifestyle changes.
Disclosure of Interest None Declared