Alcohol consumption does not increase risk of inflammatory bowel disease
Alcohol consumption does not appear to present a risk of developing either ulcerative colitis (UC) or Crohn’s disease (CD), according to a study.
The study drew data from the European Prospective Investigation into Cancer and Nutrition (EPIC-IBD), including 1,410 participants in six countries who completed validated food frequency and lifestyle questionnaires. The UC cohort comprised 198 UC patients and 792 controls, while the CD cohort consisted of 84 CD patients and 336 controls.
Alcohol consumption was expressed as consumption at enrolment and during lifetime. Consumption levels were classified as follows: nonuse, former, light (≤0.5 and 1 drink per week for women and men, respectively), below the recommended limits (BRL; ≤1 and 2 drinks per day), moderate (≤2.5 and 5 drinks per day) or heavy use (>2.5 and >5 drinks per day).
Conditional logistic regression analysis was performed using light alcohol users as the reference, and adjustments were made for smoking and education.
At enrolment, in the UC cohort, 8 percent of patients were nonusers of alcohol, 27 percent light users, 32 percent BRL users, 23 percent moderate users and 11 percent heavy users. Among CD patients, the corresponding figures were 7, 29, 40, 19 and 5 percent.
The corresponding figures for lifetime nonuse, former, light, BRL, moderate and heavy alcohol use were 3, 5, 23, 44, 19 and 6 percent among UC patients, and 5, 2, 25, 44, 23 and 1 percent among CD patients. Based on the unadjusted and adjusted odds ratios, no associations between any categories of alcohol consumption and risk of UC or CD were observed.
Inflammatory bowel disease (IBD), including CD and UC, is a chronic relapsing inflammatory disorder of the intestine. While the causes are unclear, the aetiology of IBD is said to involve interactions among microbial, genetic, environmental and immunological factors. [Gastroenterology 2004;126:1504–1517]
In relation to the disease, alcohol may provide protection by inhibiting the systemic immune system and neutrophil migration, and owing to the antioxidant contents (eg, resveratrol) that have anti-inflammatory properties. Conversely, alcohol can also contribute to an increase in the expression of proinflammatory mediators such as tumour necrosis factor-α, interleukin-1 (IL-1), and IL-6. It can disrupt gut barrier function and increase intestinal permeability, to which patients with IBD are particularly vulnerable. [PLoS One 2016;11:e0165411]