Chronic inflammatory bowel disease and the 'over-clean' environment: rarity in the Irish 'traveller' community.
The causes of ulcerative colitis and Crohn's disease are unknown. Current research is focused on genetic factors but environmental factors may also be important. Exposure to infections in early life is believed to reduce the incidence of bronchial asthma. We hypothesised that exposure to enteric bacteria and infections in early life may also reduce the incidence of idiopathic inflammatory bowel disease. Chronic inflammatory bowel disease may be a by-product of our over-clean environment. Social groups with poorer living standards might be expected to have a lower prevalence of this condition. The "traveller" or itinerant community in Ireland is one such group. We therefore attempted to estimate the prevalence of inflammatory bowel disease in the traveller population. Twenty five of 30 gastroenterologists or surgeons in Ireland responded to requests for information. None could recall ever seeing a "traveller" with idiopathic inflammatory bowel disease. While genetic factors cannot be excluded, a low prevalence of idiopathic inflammatory bowel disease would support the environmental hypothesis.
McCormick
P
P
Liver Unit, St Vincent's University Hospital, Dublin, Ireland.
Manning
D
D
D002908:Chronic Disease; D004777:Environment; D005762:Gastroenterology / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D006920:Hygiene; D007113:Immunity, Innate / Q000235:genetics; D015994:Incidence; D007239:Infections / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000208:ethnology* / Q000209:etiology*; D007494:Ireland / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D006178:Romani People / Q000706:statistics & numerical data*; D012499:Sanitation / Q000592:standards / Q000706:statistics & numerical data