Modifiable Environmental Factors in Inflammatory Bowel Disease

Kristin E. Burke, Christine Boumitri, Ashwin N. Ananthakrishnan*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


Purpose of Review: Environmental factors may influence predisposition to develop inflammatory bowel diseases (Crohn’s disease, ulcerative colitis) or alter its natural history by modification of both the host immune response and intestinal microbial composition. The purpose of this review is to translate such evidence into clinical practice by a focus on interventional studies that have modified such environmental influences to improve disease outcomes. Recent Findings: Several environmental influences have been identified in the recent literature including tobacco use, diet, antibiotics, vitamin D deficiency, stress, appendectomy, and oral contraceptive use. Some risk factors have similar influences on both Crohn’s disease and ulcerative colitis while others are disease-specific or have divergent effects. Summary: Emerging epidemiologic evidence has confirmed the association of many of these factors with incident disease using prospective data. In addition, laboratory data has supported their mechanistic plausibility and relevance to intestinal inflammation.

Original languageEnglish (US)
Article number21
JournalCurrent gastroenterology reports
Issue number5
StatePublished - May 1 2017


  • Crohn’s disease
  • Diet
  • Environment
  • Smoking
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology


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