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Risk factors

By Mayo Clinic staff

Risk factors for Crohn's disease may include:

  • Age. Crohn's disease can occur at any age, but you're likely to develop the condition when you're young. Most people are diagnosed with Crohn's between the ages of 20 and 30.
  • Ethnicity. Although whites have the highest risk of the disease, it can affect any ethnic group. If you're of Ashkenazi Jewish descent, your risk is even higher.
  • Family history. You're at higher risk if you have a close relative, such as a parent, sibling or child, with the disease. As many as 1 in 5 people with Crohn's disease has a family member with the disease.
  • Cigarette smoking. Cigarette smoking is the most important controllable risk factor for developing Crohn's disease. Smoking also leads to more severe disease and a greater risk of surgery. If you smoke, stop. Discuss this with your doctor and get help. There are many smoking-cessation programs available if you are unable to quit on your own.
  • Where you live. If you live in an urban area or in an industrialized country, you're more likely to develop Crohn's disease. Because Crohn's disease occurs more often among people living in cities and industrial nations, it may be that environmental factors, including a diet high in fat or refined foods, play a role in Crohn's disease. People living in northern climates also seem to have a greater risk of the disease.
  • Isotretinoin (Accutane) use. Isotretinoin (Accutane) is a powerful medication sometimes used to treat scarring cystic acne or acne that doesn't respond to other treatments. Although cause and effect hasn't been proved, studies have reported the development of inflammatory bowel disease with isotretinoin use.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Although these medications — ibuprofen (Advil, Motrin, others), naproxen (Aleve), diclofenac (Cataflam, Voltaren), piroxicam (Feldene), and others — haven't been shown to cause Crohn's disease, they can cause similar signs and symptoms. Additionally, theses medications can make existing Crohn's disease worse.
Complications Causes
References
  1. Crohn's disease: Clinical features. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. Saunders Elsevier; Philadelphia, Pa.: 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/810.html?tocnode=51643270&fromURL=810.html#4-u1.0-B1-4160-0245-6..50113-X--cesec14_5163. Accessed June 21, 2009.
  2. Crohn's disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/. Accessed June 21, 2009.
  3. Crohn's disease. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec02/ch018/ch018b.html. Accessed June 17, 2009.
  4. Peppercorn MA. Clinical manifestations, diagnosis and natural history of Crohn's disease in adults. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
  5. Living with Crohn's disease. The Crohn's and Colitis Foundation of America. http://www.ccfa.org/frameviewer/?url=/media/pdf/crohns2005.pdf. Accessed June 17, 2009.
  6. Werman HA, et al. Ileitis, colitis, and diverticulitis. In: Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, N.Y.: McGraw Hill; 2004. http://www.accessmedicine.com/content.aspx?aID=592744. Accessed June 21, 2009.
  7. Learning about Crohn's disease. National Human Genome Research Institute. http://www.genome.gov/pfv.cfm?pageID=25521854. Accessed June 17, 2009.
  8. Inflammatory bowel disease. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/144932667-4/854785995/1621/261.html#4-u1.0-B978-1-4160-4435-2..50133-3--cesec17_2085. Accessed June 21, 2009.
  9. Accutane (prescribing information). Nutley, N.J.: Roche. 2008. http://www.rocheusa.com/products/accutane/pi.pdf. Accessed June 23, 2009.
  10. Draganov PV. Colorectal cancer surveillance in inflammatory bowel disease: The search continues. World Journal of Gastroenterology. 2009;15:61.
  11. Ingle SB, et al. The natural history of perianal Crohn's disease. Digestive and Liver Disease. 2007; 39:963.
  12. Piton G, et al. Big risk, small risk: Small bowel cancer in Crohn's disease. Inflammatory Bowel Diseases. In press. Accessed June 23, 2009.
  13. Crohn's disease: Treatment. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/144932667-3/0/1389/813.html?tocnode=51643292&fromURL=813.html#4-u1.0-B1-4160-0245-6..50113-X--cesec36_5185. Accessed June 21, 2009.
  14. Rutgeerts P, et al. Biological therapies for inflammatory bowel diseases. Gastroenterology. 2009;136:1182.
  15. FDA approves new treatment for Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
  16. FDA approves Cimzia to treat Crohn's disease. U.S. Food and Drug Administration. Accessed June 23, 2009.
  17. FDA approves Tysabri to treat moderate-to-severe Crohn's disease: Drug currently approved for use in treating some forms of multiple sclerosis. Accessed June 23, 2004.
  18. Diet and nutrition. Crohn's and Colitis Foundation of America. http://www.ccfa.org/info/diet. Accessed June 23, 2009.
  19. Markowitz J, et al. Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease. Inflammatory Bowel Diseases. 2004;10:599.
  20. Enck P. Acupuncture treatment in gastrointestinal diseases: A systematic review. World Journal of Gastroenterology. 2007;13:3417.
  21. Korzenik JR. Investigational therapies in the medical management of Crohn's disease. http://www.uptodate.com/home/index.html. Accessed June 16, 2009.
  22. Picco MF (expert opinion). Mayo Clinic. Jacksonville, Fla. July 9, 2009.
  23. Follow-up to the June 4, 2008, early communication about the ongoing safety review of tumor necrosis factor (TNF) blockers (marketed as Remicade, Enbrel, Humira, Cimzia and Simponi). Food and Drug Administration. Accesed August 4, 2009.

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Aug. 8, 2009

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