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To learn more concerning possible familial factors in Crohn's disease and ulcerative colitis (two conditions involving bowel inflammation), a study of first- and second-degree relatives of 637 patients (504 with colitis, 133 with Crohn's disease) was carried out. The patients, all residents of Copenhagen county in Denmark, had been diagnosed according to criteria that are listed in the report. They received a questionnaire in the mail that included items about family history and family members with inflammatory bowel disease. Patients who listed affected family members were contacted by telephone to learn more concerning these members' illnesses; the medical records of the family members were then examined. Sex- and age-adjusted risk levels for Crohn's disease and ulcerative colitis in first- and second-degree relatives (only sex-adjusted for second-degree relatives) were calculated and compared with risk levels among the general population. Results showed that 60 patients had relatives with inflammatory bowel disease; some had more than one affected relative. As compared with disease rates in the general population, first-degree relatives of patients with ulcerative colitis had 9.5 and 1.8 times the prevalence rates of ulcerative colitis and Crohn's disease, respectively. Among first-degree relatives of patients with Crohn's disease, prevalence rates for Crohn's disease and ulcerative colitis were elevated 10.3 times and 4.4 times greater. Prevalence rates for the same disease as the patients were also elevated among second-degree relatives. Overall, the study showed that first-degree relatives of people with ulcerative colitis or Crohn's disease have 10 times the risk of developing that disease as the general population. A review of the medical literature concerning familial occurrence of inflammatory bowel disease and possible sources of bias is presented. Although a shared environment is unlikely to lead to increased relative risks of the magnitude found, the relative contributions of genetic and environmental factors cannot be sorted out in such a study. (Consumer Summary produced by Reliance Medical Information, Inc.)

Inflammatory bowel disease is a painful and debilitating class of conditions in which portions of the lower intestine become inflamed and ulcerated, leading to nausea, vomiting, diarrhea, and other symptoms. Perforation of the affected intestinal segment can be fatal. Significant health care expenditures are directed at the care, treatment, and rehabilitation of patients suffering from inflammatory bowel disease. To investigate the distribution of inflammatory bowel disease among workers in West Germany, where the socialized medicine system provides a large database on medical treatment administered to all citizens, records of all patients treated between 1982 and 1988 were analyzed. A total of 12,014 patients were treated for the two most prevalent types of inflammatory bowel disease, Crohn's disease, which affects the ileum, and ulcerative colitis, which affects the colon. Among men, the disease incidence was lower for individuals engaged in physically strenuous work such as bricklaying, road construction, and unskilled labor of various types. A high incidence of the disease was seen among instrument makers, electricians, bakers, and technical assistants. Among women, low rates of inflammatory bowel disease were seen among those involved in cleaning and maintenance professions, or those who stayed at home, while higher rates were associated with professions such as sales representative, hairdresser, and health occupations. These patterns appeared to be stable over the six-year period that was analyzed and suggest that occupations involving physical labor or outdoor work may confer a protective benefit. Conversely, artificial and sedentary working conditions may increase the risk of developing inflammatory bowel disease. (Consumer Summary produced by Reliance Medical Information, Inc.)