Last Updated on June 22, 2023 by Steven Root
Crohn’s Disease Causes vs Crohn’s Disease Triggers
Crohn’s disease causes, similar to Crohn’s disease triggers, are thought to be many. Whilst Crohn’s disease causes are thought to be the instigating factors behind the development of the disease, Crohn’s disease triggers are often thought to be causal of Crohn’s disease symptoms post diagnosis. Though, the terms are often used interchangeably.
Included in this article, both Crohn’s disease causes and Crohn’s disease triggers are discussed as there is strong overlap between the two. We shall explore:
- The Definition of Environmental Factors
- Western Lifestyle and Diet
- Smoking’s Impact
- Medications as Triggers
- Stress and Anxiety Connection
- Hygiene Hypothesis
- Exposure to Pollutants
- Genetic Interplay
- Prevention and Management
Crohn’s disease is an inflammatory bowel disorder characterized by abdominal pain, diarrhea, fatigue, rectal bleeding, and a host of other systemic issues. While the exact cause remains elusive, research suggests that a confluence of genetic and environmental factors plays a pivotal role. This article delves into the various environmental components that contribute to Crohn’s disease causes.
Defining Environmental Factors
Environmental factors encompass anything that’s not genetic. These factors, including lifestyle choices, exposure to chemicals, and medications, could potentially increase the risk of developing Crohn’s disease, as well as trigger a Crohn’s disease flare-up.
The Western Lifestyle: A Double-Edged Sword
The Western diet and lifestyle has many perks such as technological advancements, varied cuisine, and entertainment. But when it comes to health, this might not be all that beneficial. Whilst it is up for debate as to whether Western diet and lifestyle is one of the fundamental Crohn’s disease causes, rather than a factor that exacerbates symptoms, it should be a key area of focus.
Studies indicate that the Western diet, by its very composition (high sugar + unhealthy fats), can create an imbalance in the gut microbiome. The gut is inhabited by trillions of microorganisms that play a significant role in digestion and immune function. A diet high in sugars and unhealthy fats can change the composition of these microorganisms, thereby making the gut more susceptible to the inflammation characteristic of Crohn’s disease.
Diet is most certainly known to be one of the major Crohn’s disease triggers, although the jury is still out as to whether or not it can be causal of Crohn’s disease.
Interestingly, it is not just the components of the diet but also the additives that can have an impact. Many processed foods contain preservatives and artificial colorings that can have detrimental effects on the gut lining. These additives might promote the growth of harmful bacteria while suppressing beneficial ones.
Another angle through which the Western lifestyle impacts Crohn’s disease is through increased stress and reduced physical activity. High-stress jobs and sedentary lifestyles can exacerbate symptoms in those who have Crohn’s disease and may contribute to its development in others.
Addressing the negative aspects of the Western lifestyle by adopting a balanced diet comprising mainly whole foods, avoiding food additives, managing stress, and staying physically active can be instrumental in reducing the risk of Crohn’s disease or managing it better if already diagnosed.
You can get help in building a dietary and lifestyle strategy to get rid of Crohn’ symptoms and keep them away here.
The Role of Smoking in Crohn’s Disease
Smoking has long been known as a leading cause of respiratory and cardiovascular diseases. However, its role in contributing to Crohn’s disease is becoming increasingly clear. Studies have shown that individuals who smoke are more likely to develop Crohn’s disease, and those with the disease who smoke tend to have more severe symptoms.
The mechanisms by which smoking contributes to Crohn’s disease are multifaceted. One theory suggests that nicotine, a component of cigarettes, contributes to inflammation and alters the immune response. This alteration in the immune response can lead to increased intestinal inflammation, which is characteristic of Crohn’s disease.
Another way smoking might contribute to Crohn’s disease is through its impact on the gut’s blood vessels. Smoking can cause blood vessels to constrict, reducing blood flow to the intestines. This reduced blood flow can impair the gut’s ability to heal and can contribute to the chronic inflammation seen in Crohn’s disease.
Interestingly, the impact of smoking on Crohn’s disease seems to be different from its effect on ulcerative colitis, another form of inflammatory bowel disease. While smoking is widely regarded one of the Crohn’s disease triggers, it might have a protective effect against ulcerative colitis. This distinction indicates a complex interaction between smoking and the pathogenesis of inflammatory bowel diseases. However, if you have ulcerative colitis, this is not reason to smoke as the risks far outweigh the benefit.
Quitting smoking is an essential part of Crohn’s disease management. If you are struggling to quit, consultation with healthcare professionals for smoking cessation programs and support is highly recommended.
Medications: Are They Always Beneficial?
Medications are designed to treat various ailments and conditions. However, it is essential to remember that medications can also have side effects and interactions that might not always be beneficial. In the context of Crohn’s disease, certain medications, notably non-steroidal anti-inflammatory drugs (NSAIDs), might have a detrimental effect on the gut lining despite often being prescribed.
NSAIDs such as ibuprofen and aspirin are commonly used to manage pain and reduce inflammation. They work by inhibiting enzymes known as COX-1 and COX-2. However, COX-1 also has a protective role in maintaining the gut lining. By inhibiting COX-1, NSAIDs can contribute to the development or exacerbation of Crohn’s disease.
Another group of medications that should be used cautiously by individuals with Crohn’s disease are antibiotics. Although sometimes necessary to treat infections, antibiotics can disrupt the gut microbiome. This disruption can sometimes lead to an overgrowth of harmful bacteria, which can contribute to intestinal inflammation.
And corticosteroids, often used to manage inflammation in Crohn’s disease, can have side effects such as bone loss, increased susceptibility to infection, and mood changes. It is essential to use these medications under the supervision of a healthcare provider and at the lowest effective dose.
Awareness and communication with healthcare providers are key when it comes to medications. Discussing the risk-reward ratio and being vigilant about the medications prescribed, can help in making informed decisions and managing Crohn’s disease effectively.
Importantly, dietary and lifestyle strategies should always be utilized alongside the use of medications to manage the condition. It should never be an ‘either / or’ decision. Focusing on your diet and lifestyle is ALWAYS the right thing to do.
The Mental Health Connection: Stress and Anxiety
Crohn’s disease is often considered a physical condition, but its ties with mental health are becoming increasingly recognized. Stress and anxiety can have a significant impact on the course of Crohn’s disease. They can most certainly trigger Crohn’s disease symptoms, and might even play a role in the onset of the disease in predisposed individuals.
The link between stress and Crohn’s disease is often explained through the gut-brain axis, a bidirectional communication channel between the gut and the brain. Stress can alter gut motility, change the composition of the gut microbiome, and increase intestinal permeability. These changes are known to contribute to the intestinal inflammation characteristic of Crohn’s disease.
Managing stress and anxiety is, therefore, an integral part of managing Crohn’s disease. Cognitive-behavioral therapy, a form of psychotherapy, can be effective in managing stress and anxiety. It helps individuals change patterns of thinking and behavior that contribute to their symptoms.
Mind-body interventions such as mindfulness, yoga, and relaxation techniques can also be beneficial. These practices can reduce stress and have a positive effect on the gut-brain axis, thereby reducing the inflammation in the gut.
Collaboration between gastroenterologists and mental health professionals can provide a more comprehensive approach to managing Crohn’s disease. Patients should be encouraged to communicate any issues related to mental health with their healthcare providers.
An excellent resource that has helped many of my clients is Letting Go by David Hawkins. The foundation of this book is the release of the emotions that often underpin our stress such as fear, anxiety, anger etc. By working through these emotions, we can reduce the amount of stress we experience which can have a major impact on our likelihood of experiencing Crohn’s symptoms.
The Hygiene Hypothesis: Too Clean for Our Good?
The hygiene hypothesis is an interesting concept that has been gaining traction in explaining the rise in autoimmune diseases, including Crohn’s. According to this hypothesis, early childhood exposure to a variety of microbes is essential for the proper development of the immune system. In highly sanitized environments, the lack of microbial exposure can lead the immune system to develop ‘improperly’, increasing the risk of autoimmune diseases.
Observational studies have shown that individuals who grew up in rural areas or had many siblings, and thereby were exposed to more microorganisms, have a lower risk of developing Crohn’s disease. This is thought to be due to the “training” of the immune system that occurs with repeated microbial exposure.
However, the hygiene hypothesis does not imply that poor hygiene is the answer. It is essential to recognize that hygiene and vaccinations have vastly reduced the incidence of many deadly infections. The goal should not be to abandon hygiene but to seek balance.
One way to do this is by encouraging more outdoor activities, especially in children. Exposure to a natural environment can provide the microbial diversity necessary for the immune system to be adequately ‘trained’. Moreover, being judicious in the use of antibacterial products and considering the role of probiotics and fermented foods can also be beneficial.
Addressing the hygiene hypothesis in public health recommendations, keeping in mind the need to protect against infectious diseases while promoting a healthy immune system, is an incredibly complicated, though crucial affair.
Air We Breathe: Exposure to Pollutants
While air pollution is well-known for its role in respiratory diseases like asthma, its impact on Crohn’s disease can also be significant. The pollutants in the air we breathe can have systemic effects on the body, including on the gastrointestinal tract.
Particle matter, nitrogen dioxide, and sulfur dioxide are some of the pollutants found to be associated with an increased risk of Crohn’s disease. These pollutants can cause oxidative stress and inflammation in the gut, contributing to the pathological processes of Crohn’s disease.
The geographic distribution of Crohn’s disease provides some insights into the role of air pollution. Urban areas with high levels of air pollution have a higher incidence of Crohn’s disease compared to rural areas. This suggests a correlation between air quality and the prevalence of Crohn’s disease, although of course urban areas also full of confounding factors such as access to fast food, etc.
Personal measures such as using air purifiers, limiting outdoor activities during days with high pollution levels, and keeping track of local air quality can help in reducing exposure to pollutants. However, addressing air pollution as a risk factor for Crohn’s disease really requires action at the societal level.
Advocating for policies that limit emissions, supporting alternative energy sources, and creating awareness about the broader health impacts of air pollution are necessary steps in protecting not only against Crohn’s disease but also in reducing the incidence of other autoimmune diseases and a multitude of respiratory illnesses.
The Genetic-Environmental Interplay
While not an environmental factor per se, genetics can influence how individuals respond to environmental triggers. Certain gene mutations may make individuals more susceptible to environmental factors that contribute to Crohn’s disease – please see this article.
Prevention and Management
Understanding the Crohn’s disease causes that stem from the environment is crucial not only for prevention but also for effective management. Adopting a healthy, targeted diet, quitting smoking, reducing stress, and minimizing exposure to pollutants are steps that can be taken to mitigate risk.
We have discussed that-
- Environmental factors contribute to the major Crohn’s disease causes.
- Crohn’s disease triggers are often thought to be causal of a flare-up post diagnosies, whereas Crohn’s disease causes are more often thought to be the instrumental factors in the initial development of Crohn’s disease.
- The Western diet, rich in processed foods, increases risk.
- Smoking is a significant risk factor.
- NSAIDs and other drugs such as antibiotics can exacerbate symptoms and increase risk.
- Stress and anxiety are intimately connected to Crohn’s disease.
- Over-cleanliness can be an issue.
- Exposure to pollutants can contribute to Crohn’s disease.
- Genetics influence susceptibility to environmental triggers.
- Prevention and management should focus on dietary and lifestyle changes, using medications where necessary.