I have IBD, will my child have IBD?

Your child may or may not develop IBD

Having a family history of IBD and having certain genes can predispose a person to developing IBD. The risk is less than 10% if one parent has IBD, and about 20-30% if both parents have IBD¹.

There are factors other than genetics that can affect the risk of developing IBD

• The environment is important . . .
  • The environment can provide triggers that lead to the development of IBD. There is a relatively high prevalence of IBD in Western and developed countries^2,3. However, the incidence of IBD is rising in developing countries. Children who immigrate take on the risk associated with the country to which they are moving⁴. Living in an urban setting is associated with an increased risk of developing IBD – this association appears to be stronger for developing Crohn’s disease than ulcerative colitis⁴.
    
    
• Smoking may play a role . . .
  • Smoking has been reported to be a risk factor for developing and worsening of Crohn’s disease, but a protective factor for developing and for decreasing disease activity in ulcerative colitis^2,3.  However, it is not recommended to smoke to decrease the risk of developing ulcerative colitis because of the risks associated with smoking (such as lung cancer, cardiovascular disease, and other health problems).
    
    
• Diet may be important . . .
  • Although studies vary, diets rich in dietary fiber (fruits and vegetables) are thought to be protective against IBD³.  Consuming excessive meat, fish, and fats may increase the risk of developing IBD^2,3.
  • Vitamin D has been found to be low in IBD patients and Vitamin D deficiency may lead to immune deregulation and increase the risk of developing IBD⁵.
    
    
• The intestinal microbiome is important . . .
  • The intestinal microbiome is made of all the bacteria in an individual’s gastrointestinal tract. It is established in infancy and childhood.
  • The microbiome helps to maintain a healthy immune system by
    • opposing certain inflammatory cytokines
    • regulating the development of immune cells that recognize foreign- and self-compounds
    • activating T regulatory cells, which can promote tolerance to microorganisms⁶
  • The intestinal microbiome needs to be balanced for each individual to have a healthy immune system.
    
    
• Many things affect the intestinal microbiome . . .
  • The intestinal microbiome can be affected by a person’s genes, their environment (including diet), overall health, infections, and medications (such as antibiotics).
    
    
• An unbalanced intestinal microbiome can lead to a dysregulated immune response . . .
  • Multiple factors interact and can lead to a change in the intestinal microbiome. An unbalanced intestinal microbiome can lead to a dysregulated immune response resulting in inflammation characteristic of inflammatory bowel disease.
  • the “hygiene hypothesis” proposes that
    • clean environments limit microbial exposure, leading to an altered immune system that is unable to differentiate between beneficial from harmful bacteria^2,3
    • the altered immune system can predispose one to exaggerated immune responses, resulting in the chronic inflammation seen in IBD

References

1. Habal F M & Huang V W. Review Article: a decision-making algorithm for the management of pregnancy in the inflammatory bowel disease patient. Aliment Pharmacol Ther. 2012 January; 35:501-515.
2. Aujnarian A, Mack D R, & Benchimol E I. The role on the Environment in the Development of Pediatric Inflammatory Bowel Disease. Curr Gastroenerol Rep. 2013 May;15(326).
3. Frolkis A et al. Environment and the Inflammatory Bowel Disease. CJG. 2013 Mar; 3:e18-e24.
4. Ng S C et al. Geographic variability and environmental risk factors in Inflammatory Bowel Disease. Gut. 2013;62:630–649.
5. Reich K M et al. Vitamin D improves Inflammatory Bowel Disease outcomes: Basic science and clinical review. World J Gastroenterol. 2014 May;20(17):4934-4947.
6. Petersen C & Round J L. Defining dybiosis and its influence on host immunity and disease. Cell Microbiol. 2014 May. Doi: 1111/cmi.12308