Crohn’s Disease: Prevention

To prevent Crohn’s disease, attention must be paid to reducing individual risk factors.

Behavioral risk factors

  • Diet
    • Food components, especially increased use of refined carbohydrates – white sugar, white flour products.
    • Low consumption of dietary fiber
    • High consumption of chemically processed edible fats
    • Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
  • Consumption of stimulants
    • Tobacco (smoking) – major risk factor for manifestation (smokers have 2 times higher risk of disease) and for complicated courses.
    • Furthermore, children of mothers who smoked during pregnancy have twice the risk of disease compared with children of non-smoking mothers
  • Psycho-social situation
    • Conflict situations
    • Stress – can lead to the occurrence of new relapses
  • Hygiene situation – regular contact with stabled animals or their excreta in the first year of life is statistically associated with a halving of the risk of developing Crohn’s disease by the age of 18 (hypothesis: lack of confrontation with parasites and microbial toxins increases the risk of “misprogramming” the immune system, leading to autoimmune diseases)

Medication

  • Repeated and early use of antibiotics, especially those with a broad spectrum of activity.
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs).
  • TNF blockers (biologics that neutralize tumor necrosis factor alpha): etanercept: adjusted hazard ratio of 2.0 (95% confidence interval 1.4 to 2.8); no increased risk was detectable for infliximab and adalimumab.

Environmental exposure – intoxications (poisonings).

Prevention factors (protective factors)

  • Genetic factors:
    • Genetic risk reduction depending on gene polymorphisms:
      • Genes/SNPs (single nucleotide polymorphism):
        • Gene: IL23R (encodes a cytokine receptor on a subpopulation (subset) of effector T cells).
        • SNP: rs11209026 in the gene IL23R
          • Allele constellation: AG (0.14-fold).
          • Allele constellation: AA (<0.14-fold)
  • Breastfeeding reduces the risk of the probability of developing Crohn’s disease by 90% (adjusted odds ratio, aOR: 0.10 (95% confidence interval between 0.04 and 0.30) if posed for at least 12 months.
  • Growing up in rural areas (Canada; esp. provinces where agriculture predominates; risk of disease 10% lower).