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Crohn's disease - Risk Factors

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of Crohn's disease.

Alternative Names

Inflammatory bowel disease - Crohn's disease

Risk Factors:

About 1 million Americans suffer from inflammatory bowel disease (IBD), and about half of these patients have Crohn's disease. There are several risk factors for Crohn� ' s disease.

Age

Crohn� ' s disease can occur at any age, but is most frequently diagnosed in people ages 15 - 35. About 10% of patients are children under age 18.

Gender

Men and women are equally at risk for developing Crohn� ' s disease.

Family History

Crohn� ' s disease tends to run in families, with 20 - 25% of patients having a close relative who also has the disease.

Race and Ethnicity

Crohn� ' s disease is more common among whites, although incidence rates have been increasing among African-Americans as well. It is less common among Latinos and Asians. Jewish people of Ashkenzi (Eastern European) descent are at 4 - 5 times higher risk than the general population.

Smoking

Smoking appears to increase the risk of developing Crohn� ' s disease, and can worsen the course of the disease. (Conversely, smoking appears to decrease the risk of ulcerative colitis. However, because of the hazards of smoking, it should never be used to protect against ulcerative colitis.)

Resources

www.ccfa.org -- Crohn's & Colitis Foundation of America
www.gastro.org -- American Gastroenterological Association
www.acg.gi.org -- American College of Gastroenterology
www2.niddk.nih.gov -- National Digestive Diseases Information Clearinghouse

References

Akobeng AK. Crohn's disease: current treatment options. Arch Dis Child. 2008;93(9): 787-92.

Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2007;(3): CD005984.

Baumgart DC and Sandborn WJ. Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet. 2007;369(9573): 1641-57.

Behm BW, Bickston SJ. Tumor necrosis factor-alpha antibody for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2008;(1):CD006893.

Benchimol EI, Seow CH, Steinhart AH and Griffiths AM. Traditional corticosteroids for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2008;(2): CD006792.

Butterworth AD, Thomas AG, Akobeng AK. Probiotics for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006634.

Clark M, Colombel JF, Feagan BC, Fedorak RN, Hanauer SB, Kamm MA, et al. American gastroenterological association consensus development conference on the use of biologics in the treatment of inflammatory bowel disease, June 21-23,2006. Gastroenterology. 2007 Jul;133(1):312-39.

Cummings JR, Keshav S and Travis SP. Medical management of Crohn's disease. BMJ. 2008;336(7652):1062-6.

Feagan BG, Sandborn WJ, Mittmann U, Bar-Meir S, D'Haens G, Bradette M, et al. Omega-3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC Randomized Controlled Trials. JAMA. 2008;299(14):1690-7.

MacDonald JK and McDonald JW. Natalizumab for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2007;(1):CD006097.

Mahid SS, Minor KS, Soto RE, Hornung CA and Galandiuk S. Smoking and inflammatory bowel disease: a meta-analysis. Mayo Clin Proc. 2006;81(11):1462-71.

Rahimi R, Nikfar S, Rahimi F, Elahi B, Derakhshani S, Vafaie M, et al. A meta-analysis on the efficacy of probiotics for maintenance of remission and prevention of clinical and endoscopic relapse in Crohn's disease. Dig Dis Sci. 2008;53(9):2524-31.

Sandborn WJ, Feagan BG, Stoinov S, Honiball PJ, Rutgeerts P, Mason D, et al. Certolizumab pegol for the treatment of Crohn's disease. N Engl J Med. 2007 Jul 19;357(3):228-238.

Schreiber S, Khaliq-Kareemi M, Lawrance IC, Thomsen OO, Hanauer SB, McColm J, et al. Maintenance therapy with certolizumab pegol for Crohn's disease. N Engl J Med. 2007 Jul 19;357(3):239-250.

Seow CH, Benchimol EI, Griffiths AM, Otley AR and Steinhart AH. Budesonide for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2008;(3):CD000296.

Strong SA, Koltun WA, Hyman NH, Buie WD; Standards Practice Task Force of The American Society of Colon and Rectal Surgeons. Practice parameters for the surgical management of Crohn's disease. Dis Colon Rectum. 2007;50(11):1735-46.

Yamamoto T, Fazio VW, Tekkis PP. Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis. Dis Colon Rectum. 2007;50(11):1968-86.

Zachos M, Tondeur M and Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2007;(1):CD000542.

Reviewed last on: 12/1/2008
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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