Family factors may increase a child’s risk of inflammatory bowel disease

By Cara Murez HealthDay Reporter

TUESDAY, May 9, 2023 (HealthDay News) — What puts children at risk for pediatric inflammatory bowel disease (IBD) and what might help prevent it?

A review of 36 observational studies involving 6.4 million children offers some key clues.

Taking antibiotics at an early age, eating a Western diet, and living in a more affluent family were associated with an increased risk of IBD. But living in a household with pets and siblings and eating lots of vegetables was linked to a lower risk.

“Cases of pediatric IBD are increasing worldwide, and approximately 1 in 4 cases of IBD are now diagnosed before the age of 21,” said the lead author. Nisha Thackera gastrointestinal dietitian who performed the meta-analysis as part of her doctoral studies at the University of Newcastle in Australia.

IBD is characterized by abdominal pain, diarrhea, and blood in the stool, indicating that parts of the intestinal tract have become inflamed.

The new analysis, presented at a conference of the American Gastroenterological Association on Sunday, found that children who took antibiotics before age 5 were at three times the risk of developing pediatric IBD. Their risk was 3.5 times higher if they had received at least four courses of antibiotics at that age.

Exposure to second-hand smoke doubled the risk of IBD.

Surprisingly, lower economic status seemed to have a protective effect: it was associated with a 65% lower risk of IBD.

Exposure to animals and having only one toilet at home were also linked to a protective effect.

For what? Thacker emphasized hygiene.

Excessive hygiene can reduce the number of microbes in the environment, which can hinder the development of a robust microbiome in children, she said. The microbiome is the community of bacteria that lives in the digestive tract and on the body.

Although basic hygiene is recommended, Thacker said letting children play outside and interact with pets is important to help build strong immune systems. In other words, there is such a thing as too clean.

“Many of these factors can impact our gut microbiota and can have a particularly strong effect in a child,” she said in a press release. “A Western diet, high in sugars and ultra-processed foods and low in vegetables, is a prime example.”

Families with young children should eat a diet rich in vegetables and minimally processed whole foods, Thacker said. She also urged families to consider adopting a pet and to take steps to prevent second-hand smoke, avoid excessive hygiene and use antibiotics with caution.

According to the study, breastfeeding and then feeding a child a healthy diet can minimize the effects of a Western diet on someone with a family history of IBD or a personal history of eczema/rhinitis.

Thacker also found that being a child of color living in a high-income country tripled the risk of pediatric IBD. She then plans to study the influence of migration on the disease.

Pediatric IBD can impact a child’s growth and progression through puberty due to the inflammation involved.

The conference was held in Chicago and online. Results presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

SOURCE: American Association of Gastroenterology, press release, May 7, 2023

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