The Role of the Environment in the Development of Pediatric Inflammatory Bowel Disease

  • Amiirah Aujnarain
  • David R. Mack
  • Eric I. BenchimolEmail author
Part of the following topical collections:
  1. Topical Collection on Pediatric Gastroenterology


The incidence of inflammatory bowel disease (IBD) is rising worldwide, with a particularly sharp increase in children. Rates are highest in North America and Europe, with rapid increases noted in developing nations adopting the Westernized environment. While many genetic risk loci have been identified that predispose people to IBD, incomplete penetrance and overlapping genotypes among patients with different phenotypes inadequately explain the etiology of these chronic diseases. Therefore, environmental risk factors have been the subject of much recent research. This article reviews the role of the environment in IBD, with particular focus on early-life exposures and pediatric-onset disease. The literature surrounding environmental risk factors is reviewed, including prenatal and perinatal exposures, the hygiene hypothesis, the urban environment, infection and antibiotic use, and secondhand tobacco smoke exposure. In addition, the possible role of the environment in altering the intestinal microbiome is addressed.


Inflammatory bowel disease Crohn’s disease Ulcerative colitis Pediatrics Epidemiology Environment Risk factors 



Eric Benchimol is supported by a Career Development Award from the Canadian Child Health Clinician Scientist Program, a Canadian Institutes of Health Research (CIHR) strategic training program.

Conflict of Interest

Amiirah Aujnarain declares that she has no conflict of interest.

David R. Mack declares that he has no conflict of interest.

Eric I. Benchimol declares that he has no conflict of interest.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Amiirah Aujnarain
    • 1
  • David R. Mack
    • 1
    • 3
  • Eric I. Benchimol
    • 1
    • 2
    • 3
    • 4
    Email author
  1. 1.Department of PediatricsUniversity of OttawaOttawaCanada
  2. 2.Department of Epidemiology and Community MedicineUniversity of OttawaOttawaCanada
  3. 3.CHEO IBD Centre, Division of Gastroenterology, Hepatology and NutritionChildren’s Hospital of Eastern OntarioOttawaCANADA
  4. 4.Institute for Clinical Evaluative SciencesOttawaCanada

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