الفهرس 
INFLAMMATORY BOWEL DISEASEOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Inflammatory bowel disease (IBD) in pediatric age group isinfluenced by the complex interactions of genes, the immune system, intestinal microbiota, and the external environment.There is currently little knowledge on environmental factors associated with its relapse.
Objective: The aim of this study is to assess the environmental risk factors of relapse of IBD in pediatric patients.
Methods: Patients diagnosed with pediatric IBD at one tertiary centre were included ina cross-sectional study. Clinical, endoscopic, medications were reported and laboratory investigations including stool analysis and culture and sensitivity. Food frequency questionnaire were obtained initially at remission and at relapse time.
Results: Fifty IBD patients were included; 30 males and 20 females with mean age of 12.91± 2.68years.Of these, 28 patients (56%) had UC and 22 patients (44%) had CD. Most of them came from Urban (76%) and (24%) from rural areas. None has family history of similar cases of IBD. About one third of them (36%) have history of previous hospital admissions, surgeries or blood transfusion and 46% were exposed to smoking. All subjects were fully vaccinated according to national program of immunization. Unexpectedly, stool culture & sensitivity for the common incriminated organisms in relapse showed positive results in only 16% of cases (14 %and 2%) for E-coli and salmonella respectively. The application offood frequency questionnaire revealed thatdisease activity index during relapses was significantly correlated to higher lipids and lower fibers dietary consumption (P-value 0.000 and 0.005) respectively.
Conclusion: Achieving disease remission is one of the main objectives in treating IBD patients. Enteric infections and certain dietary habits are important environmental risk factors for IBD relapse. Patients presenting with relapse of IBD should have stool examined microbiologically and are candidates for dietary modification. This might lead to not only relief of symptoms but also a better quality of life.