To prevent ulcerative colitis, attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Diet
- Dietary factors and dietary components, especially low consumption of complex carbohydrates and dietary fiber, respectively.
- Nutritive allergens, especially the proteins of cow’s milk are essential – people who were not breastfed as infants and fed on cow’s milk are more likely to develop ulcerative colitis
- Micronutrient deficiency (vital substances) – see prevention with micronutrients.
- Consumption of stimulants
- Alcohol (woman: > 40 g/day; man: > 60 g/day).
- Psycho-social situation
- Psychosomatic maladjustment – lack of interpersonal contact, conflict situations, stress.
- Stress – it is suspected that stress may play a role in the development of ulcerative colitis. However, the study results are not yet clear
- 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 ulcerative colitis 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)
Disease-related risk factors
- Depression and anxiety
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 1.5 to 2.8); no increased risk was detectable for infliximab and adalimumab.
Environmental exposure – intoxications (poisonings).
- Environmental factors – influence of bacteria, viruses as well as pollutants leading to infections as well as inflammation of the intestinal mucosa [4.2].
Prevention factors (protective factors)
- Genetic factors:
- Genetic risk reduction depending on gene polymorphisms:
- Genes/SNPs (single nucleotide polymorphism):
- Gene: IL23R
- SNP: rs2395185 in an intergenic region.
- Allele constellation: GT (0.88-fold).
- Allele constellation: TT (0.58-fold)
- SNP: rs11209026 in the gene IL23R
- Allele constellation: AG (0.33-fold).
- Allele constellation: AA (< 0.33-fold)
- Genes/SNPs (single nucleotide polymorphism):
- Genetic risk reduction depending on gene polymorphisms:
- Breastfeeding reduces the risk of the probability of developing ulcerative colitis by 84% (aOR: 0.16; 95% confidence interval between 0.08 and 0.31) when posed for at least 12 months.
- Growing up in rural areas (Canada; esp. provinces where agriculture predominates; disease risk 10% lower).
