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Controversial role of alcohol consumption in the development of inflammatory bowel diseases

European Journal of Clinical Nutrition volume 72, page 304 (2018)Cite this article

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We read with great interest the article by Bergmann et al. [1] recently published in European Journal of Clinical Nutrition. In their European Prospective Cohort Study (EPIC), no association was found between any categories of alcohol consumption and the risk of inflammatory bowel diseases (IBD), including the subtypes of ulcerative colitis (UC) and Crohn’s disease (CD). This was controversial with another prospective study of Porter et al. [2] recently published in Alimentary Pharmacology and Therapeutics, in which moderate alcohol consumption was associated with lower UC risk (adjusted HR: 0.35, 95% CI: 0.19–0.64). We found a significant difference in the distribution of incident cases between these two studies (198 UC and 84 CD in Bergmann et al.; 58 UC and 49 CD in Porter et al.; χ 2 = 8.833, P = 0.003). Namely, the incidence of UC was about 2.5 times higher than CD in the study of Bergmann et al., while UC and CD had a similar incidence in the study of Porter et al. This might contribute to the small size of cases, which could also lead to the fluctuation in results. Thus, studies with large sample sizes were needed to reach a stable result. In the large-scale study of Wang et al. (1308 UC and 1308 controls), both light and heavy alcohol consumption were associated with UC risk (OR (95% CI): 1.264 (1.073–1.490); 1.453 (1.122–1.882)) [3]. Furthermore, we thought the most direct approach to evaluate the role of alcohol was to compare the incidence of IBD in cohorts with different levels of alcohol consumption. In the study of Hsu et al. [4], alcohol intoxication cohort (N = 57611) had a higher incidence of CD (adjusted HR: 4.40, 95% CI: 2.58–7.51) and UC (2.33 (1.39–3.90)) than non-alcohol intoxication cohort (N = 230,444) during the 10-year follow-up. Additionally, several studies also evaluated the effects of alcohol consumption in disease activity. The studies by Cohen et al. [5] and Swanson et al. [6] found that alcohol consumption could worsen gastrointestinal symptoms and increase the relapse risk in IBD patients.

In conclusion, current evidence tends to suggest an association between alcohol consumption and IBD risk.

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References

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Authors and Affiliations

  1. Department of Medical Records, The Central Hospital of Enshi Autonomous Prefecture, Enshi, 445000, China

    Xue-Ying Yang

  2. Department of Gastroenterology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, 445000, China

    Wen-Bin Wei, Li-Rong Zeng, Jian-Hua He & Peng-Fei Chen

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Correspondence to Jian-Hua He or Peng-Fei Chen.

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Yang, XY., Wei, WB., Zeng, LR. et al. Controversial role of alcohol consumption in the development of inflammatory bowel diseases. Eur J Clin Nutr 72, 304 (2018). https://doi.org/10.1038/s41430-017-0028-3

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