Poster 1062 Urban Birthplace May Be Associated With a More Severe Disease Phenotype in a Hispanic Immigrant Inflammatory Bowel Disease Cohort
Author Insight from Nirupama Bonthala, MD, MS, University of Southern California
What’s new here and important for clinicians?
Global epidemiological trends suggest that inflammatory bowel disease (IBD) is associated with industrialization. Our goal was to determine if urban exposure at birth influences phenotype and severity of IBD.
Our study in 259 patients with IBD, of whom 61% are Hispanic, demonstrates that those born in an urban setting were more likely to have Crohn’s disease. Furthermore, in Crohn’s disease, early urban exposure may be linked to a more severe disease phenotype, with an earlier age of onset and higher rates of surgery. In ulcerative colitis, those born in an urban environment had higher rates of pancolitis compared to those born in rural areas or small towns. This effect persisted after controlling for factors such as family history, NSAID use, smoking or being born outside of the United States.
Further study is warranted to identify specific factors within an urban environment that may explain these differences.
What do patients need to know?
Inflammatory bowel disease (IBD) is a complex condition that includes Crohn’s disease and ulcerative colitis. While we do not know the exact cause, we believe both genetics and the environment play a large role. Only recently are researchers evaluating what impact the environment may have on the disease course of IBD.
Our study shows that those born in urban or suburban areas are more likely to have one type of IBD called Crohn’s disease. They may also be younger when diagnosed and may have a greater need for surgery throughout their lives. This suggests that the early birth environment may play a larger role than previously thought.
It is important for patients to make their doctors aware of their environmental history, since this may aid in understanding the course of their disease.
Author Contact Nirupama Bonthala, MD, MS, University of Southern California
Twitter: @BonthalaMD
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