Inflammatory Bowel Disease and Industrialization

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Inflammatory Bowel Disease (IBD) is a chronic and relapsing gastrointestinal condition currently affecting a total of about 28 million people worldwide (cite). Although it is not considered a fatal condition, painful and disabling symptoms can have a profound detrimental effect on patients’ quality of life. Current understandings behind the etiology of IBD emphasize genetic predispositions to gastrointestinal immune system imbalances. However, pathophysiological understandings of IBD seem to be limited as explanatory tools given the distribution of IBD cases in industrialized and non-industrialized countries. Therefore, this paper will provide an overview of the biological aspect of IBD alongside significant environmental drivers of the disease. Of biggest concern will be the role of helminthes eradication in industrialized nations in accordance with the hygiene hypothesis for autoimmune diseases. Other lifestyle factors, like diet, smoking, and occupation will also be discussed.

Overview of IBD Immunogenetics
IBD is a group of chronic disorders that cause inflammation of the gastrointestinal (GI) tract. It is generally separated into two categories, ulcerative colitis and Crohn’s disease. A primary difference between the two categories is that ulcerative colitis is characterized by a more superficial, colonic inflammation that affects the mucosa and submusoca while Crohn’s disease is more discontinuous, transmural inflammation occurring anywhere along the gastrointestinal tract. Twin studies provide evidence that there is a genetic predisposition for IBD (cite). Some patients harbor susceptibility genes that leave them at higher risk for acquiring both Crohn’s and ulcerative colitis. Bacteria, which are plentiful in the inte...

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Podolsky, D. K. (1991). Inflammatory bowel disease. New England Journal of Medicine, 325(13), 928-937.

Rook, G. A. W. (2012). Hygiene hypothesis and autoimmune diseases. Clinical reviews in allergy & immunology, 42(1), 5-15.

Sonnenberg, A. (1990). Occupational distribution of inflammatory bowel disease among German employees. Gut, 31(9), 1037-1040.

Soon, S., Molodecky, N. A., Rabi, D. M., Ghali, W. A., Barkema, H. W., & Kaplan, G. G. (2012). The relationship between urban environment and the inflammatory bowel diseases: a systematic review and meta-analysis. BMC gastroenterology, 12(1), 51.

Turan, M. T., & Besirli, A. (2008). Impacts of urbanization process on mental health. Anatolian Journal of Psychiatry, 9, 238-243.

Weinstock, J. V., & Elliott, D. E. (2009). Helminths and the IBD hygiene hypothesis. Inflammatory bowel diseases, 15(1), 128-133.

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