Environmental factors in familial Crohn's disease in Belgium.
BACKGROUND
Environmental factors are believed to trigger the onset of Crohn's disease (CD) in genetically susceptible individuals. The aim of this study was to assess environmental and familial factors that might be etiologically related to CD.


METHODS
Twenty-one families with 3 or more affected first-degree relatives were studied, together with 10 matched control families. There were 74 patients with CD, 84 unaffected family members, and 59 controls. Family members were interviewed together at the parental home. A 176-item questionnaire delved into first symptoms, childhood vaccinations and diseases, food items, potable water supplies, social activities, travel, pets, and home and surrounding environment. Questions were directed specifically for 2 time-frames, childhood until age 20 and a 10-year epoch before the onset of first symptoms within a family. The possible factors linked to disease were evaluated using univariate and multivariate logistic regression.


RESULTS
There were significantly more smokers in the patients and their relatives than in controls. Patients had more appendicitis during adolescence, ate less oats, rye, and bran than controls, and consumed more unpasteurized cheese. Patients drank significantly less tap water and more well water than controls. Clustering of cases in time occurred in 13 of the 21 affected families.


CONCLUSIONS
The less frequent consumption of oats, rye, and bran and the more frequent eating of unpasteurized cheeses imitate potential dietary influences on gastrointestinal flora. More importantly, our data suggest that the drinking of well water represents an important risk factor for CD.
Van Kruiningen
Herbert J
HJ
Department of Pathobiology, University of Connecticut, Storrs, Connecticut 06269-3089, USA. herbert.vankruiningen@uconn.edu
Joossens
Marie
M
Vermeire
Severine
S
Joossens
Sofie
S
Debeugny
Stéphane
S
Gower-Rousseau
Corinne
C
Cortot
Antoine
A
Colombel
Jean-Frédéric
JF
Rutgeerts
Paul
P
Vlietinck
Robert
R
D000293:Adolescent; D000328:Adult; D001530:Belgium; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003424:Crohn Disease / Q000235:genetics*; D004032:Diet; D004522:Educational Status; D004777:Environment; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors