Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Clin Epidemiol. 2013 Jul 25;5:237-47. doi: 10.2147/CLEP.S33961. Print 2013.
Inflammatory bowel diseases (IBD), including both Crohn's disease and ulcerative colitis, are disorders of chronic inflammation of the gastrointestinal tract marked by episodes of relapse and remission. Over the past several decades, advances have been made in understanding the epidemiology of IBD. The incidence and prevalence of both Crohn's disease and ulcerative colitis have been increasing worldwide across pediatric and adult populations. As IBD is thought to be related to a combination of individual genetic susceptibility, environmental triggers, and alterations in the gut microbiome that stimulate an inflammatory response, understanding the potentially modifiable environmental risk factors associated with the development or the course of IBD could impact disease rates or management in the future. Current hypotheses as to the development of IBD are reviewed, as are a host of environmental cofactors that have been investigated as both protective and inciting factors for IBD onset. Such environmental factors include breast feeding, gastrointestinal infections, urban versus rural lifestyle, medication exposures, stress, smoking, and diet. The role of these factors in disease course is also reviewed. Looking forward, there is still much to be learned about the etiology of IBD and how specific environmental exposures intimately impact the development of disease and also the potential for relapse.
炎症性肠病（IBD）包括克罗恩病和溃疡性结肠炎，是一种胃肠道慢性炎症性疾病，其特征为反复发作和缓解。在过去几十年中，人们对 IBD 的流行病学有了更多的了解。在儿科和成人人群中，克罗恩病和溃疡性结肠炎的发病率和患病率在全球范围内都有所增加。由于 IBD 被认为与个体遗传易感性、环境触发因素以及肠道微生物组的改变有关，这些改变会刺激炎症反应，因此了解与 IBD 发展或病程相关的潜在可改变的环境风险因素可能会对未来的疾病发生率或管理产生影响。本文回顾了目前关于 IBD 发病机制的假说，以及一系列被认为是 IBD 发病保护和激发因素的环境共同因素。这些环境因素包括母乳喂养、胃肠道感染、城市与农村生活方式、药物暴露、压力、吸烟和饮食。本文还回顾了这些因素对疾病病程的作用。展望未来，仍有许多关于 IBD 病因以及特定环境暴露如何密切影响疾病发展和复发的知识有待研究。
