Cluster of inflammatory bowel disease in three close college friends?

Although the etiology of inflammatory bowel disease remains unknown, current evidence favors the interplay of genetic predisposition with environmental factors. Clustering of inflammatory bowel disease in spouses had been described, and supports a role for an environmental agent. We describe three unrelated, unmarried men all attorneys who enjoyed a close, sustained friendship in college, and who within a decade of their contact developed inflammatory bowel disease. We describe the nature of their college contact, the course of their inflammatory bowel disease, and relate our cluster to the scanty literature on clustering in inflammatory bowel disease. Physicians should report similar observations to illuminate the roles of genetics and environment in the development of these illnesses.