Causes of ulcerative colitis: What factors trigger the disease?

August 8, 2022


When a person is diagnosed with a chronic disease such as ulcerative colitis, they often feel vulnerable, confused, and worried. These feelings and concerns are not just about their own health or their future. It often raises serious concerns about the potential impact of this disease on their offspring. That is why, in the process of learning to live with the disease, patients often need to know the causes of the disease.

In the case of ulcerative colitis, science does not yet have a clear answer. The causes of ulcerative colitis are not known. That is, the specific cause of the inadequate inflammatory response of the immune system in the intestinal mucosa is unknown. However, the researchers are determined to provide an answer to this question. Several studies suggest that the appearance of ulcerative colitis1 may be the result of a complex interaction between various genetic and environmental factors.

Is it genetic predisposition? The causes of ulcerative colitis pointed out by science

Under normal conditions, the intestinal immune system is exposed to many potentially harmful substances and commensal bacteria that are part of our intestinal flora. The immune system is responsible for maintaining a stable balance between intestinal tolerance responses to commensal bacteria and inflammatory responses to pathogens.

However, sometimes there are failures in these responses. Inappropriate and exaggerated responses to bacteria whose presence should be tolerated are triggered. This marks the onset of the disease. Therefore, science considers that ulcerative colitis may be the result of a rupture of the balance between the immunity of the intestinal mucosa and the commensal intestinal flora.

The origin of these failures in the responses of the intestinal immune system is not entirely known, but it is believed to be due to genetic alterations. These can be transmitted to the descendants of patients with UC. However, UC is not considered a hereditary disease in the strict sense. Between 8 and 14% of patients with Ulcerative Colitis have a family history of inflammatory bowel disease. But its manifestation is also influenced by external factors.
Other studies have focused on environmental factors, such as tobacco.

Risk factors that favor the appearance of ulcerative colitis

According to the latest studies, the incidence of ulcerative colitis is between 7 and 10 cases per 100,000 inhabitants2. In fact, it is more prevalent in developed countries with an industrialized lifestyle. Moreover, a study published by the American Journal of Gastroenterology in 20193 shows that people, especially children, who have lived in rural areas have a lower risk of suffering any IBD.

On the other hand, age is a risk factor that influences the appearance of this inflammatory disease. Although the pathology can appear at any age, there is a higher prevalence of ulcerative colitis in the population between 15 and 30 years old. Besides, an increasing number of cases are being diagnosed among children between the ages of 7 and 12. What is the reason? It is probably due to lower exposure to infections during childhood4 and as a consequence the immune system of the intestinal mucosa has poor maturation.

Race or ethnic origin is another risk factor that favors the appearance of ulcerative colitis: white people, especially those with Jewish ancestry of European origin, are more likely to suffer from ulcerative colitis: 5 times more than any other ethnic group.

Diet, NSAIDs and tobacco, do they influence the onset of the disease?

Until a few years ago it was believed that the diet a patient had led during his life could be the cause of the development of an Inflammatory Bowel Disease. But no scientific evidence of it has been found. However, diet can help reduce symptoms and their intensity when the patient has been diagnosed and has a relapse.

The use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) is not associated with the onset of ulcerative colitis or with relapse, although some patients have experienced relapses after using them. Therefore, it is essential to be cautious with taking these medicines. It is always necessary to consult with a medical professional.

For its part, tobacco is directly linked to the development of IBD. In fact some studies claim that tobacco is a protective factor against ulcerative colitis5. So much so, that the evolution of the disease in smokers with ulcerative colitis is more moderate compared to that of non-smokers. Even in those who stop smoking, the activity of ulcerative colitis increases. It should not be forgotten, however, that tobacco causes other types of disease, so its use is really not recommended.


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