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Childhood physical, sexual abuse associated with increased risk for developing ulcerative colitis
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Adults who were physically or sexually abused during childhood had an estimated twofold increased risk for developing ulcerative colitis, according to data from a Canadian population-based study.
“We found that one-quarter of adults with ulcerative colitis reported they had been physically abused during their childhood, compared to one in 10 of those without inflammatory bowel disease,” Esme Fuller-Thomson, PhD, who holds the Sandra Rotman Endowed Chair at University of Toronto's Factor-Inwentash Faculty of Social Work, said in a press release. “Similarly, the prevalence of childhood sexual abuse among those with ulcerative colitis was one in five versus one in 17 among those without the disease.”
Fuller-Thomson and colleagues used data from the 2012 Canadian Community Health Survey —Mental Health (CCHS-MS; n = 21,852 respondents) to explore associations between Crohn’s disease or ulcerative colitis and adverse childhood experiences, including physical abuse, sexual abuse and witnessing parental domestic violence, compared with individuals without IBD. The analysis was adjusted for socioeconomic factors, health behaviors, mental health and demographics.
Compared with individuals who had not experienced physical abuse, “the odds of ulcerative colitis were more than two times higher for those who reported that an adult had at least once kicked, bit, punched, choked, burned or physically attacked them before the age of 16,” Joanne Sulman, MSW, adjunct lecturer at University of Toronto, said in the release. “Occurrences of ulcerative colitis were also more than twice as high in individuals who reported that during their childhood an adult had forced them or attempted to force them into any unwanted sexual activity, by threatening them, holding them down or hurting them, in comparison to those who had not been sexually abused. These strong associations remained even after we took into account sociodemographic characteristics, mental health conditions and health behaviors.”
Fully adjusted odds ratios for ulcerative colitis were 2.28 (95% CI, 1.39-3.75) for those who reported childhood physical abuse and 2.64 (95% CI, 1.61-4.33) for those who reported childhood sexual abuse.
“In contrast to the strong association between childhood maltreatment and ulcerative colitis, we found no association between either type of abuse and Crohn's disease,” Keri J. West, MSW, a master's student at University of Toronto, said in the release. “This was very surprising because Crohn's disease and ulcerative colitis are two forms of inflammatory bowel disease and we expected that similar links would be apparent for the two disorders. We do not know why these differences exist but it's possible that epigenetics plays a role.”
“This research was based on a cross-sectional survey and therefore we cannot determine a cause and effect relationship,” Stephanie L. Baird, MSW, said in the release. “However, with such a high proportion of subjects with ulcerative colitis reporting childhood maltreatment, future research is clear[ly] warranted.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.
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