Changing diet and better hygiene in India may be factors in the increase in Crohn’s disease

There is a worldwide increase in Crohn’s disease (CD), with an increasing number of cases in the developing world. India, undergoing rapid industrialization, is experiencing changes in diet and hygiene—and these changes are accompanied by an increase in CD. A recent hospital-based study tested the hypothesis that lifestyle and hygiene-related environmental factors would be associated with CD in India.

"Alterations in intestinal biota due to changing diet and better hygiene may tilt the balance away from tolerance and towards intestinal inflammation."
-B.S. Ramakrishna, MD, DM, MNAMS, head, Department of Medical Gastroenterology, Christian Medical College, Vellore, India

Consecutive patients with CD presenting at a hospital clinic were enrolled between September 2006 and December 2008 (n=200); control subjects in the same age ranges also were enrolled (n=200). Characteristics of the 2 groups were comparable, although the patients with CD had poorer nutrition and shorter stature overall vs the control group.

Participants were interviewed. Socioeconomic status was determined using the modified Kuppuswamy’s scale (validated for India). The social score was based on...

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