Environmental factors in the relapse and recurrence of inflammatory bowel disease: A review of the literature

Thomas D. Martin, Simon S. M. Chan, Andrew R. Hart

Research output: Contribution to journalArticlepeer-review

51 Citations (Scopus)


The causes of relapse in patients with Crohn's disease (CD) and ulcerative colitis (UC) are largely unknown. This paper reviews the epidemiological and clinical data on how medications (non-steroidal anti-inflammatory drugs, estrogens and antibiotics), lifestyle factors (smoking, psychological stress, diet and air pollution) may precipitate clinical relapses and recurrence. Potential biological mechanisms include: increasing thrombotic tendency, imbalances in prostaglandin synthesis, alterations in the composition of gut microbiota, and mucosal damage causing increased permeability.
Original languageEnglish
Pages (from-to)1396-1405
Number of pages10
JournalDigestive Diseases and Sciences
Issue number5
Early online date19 Nov 2014
Publication statusPublished - May 2015


  • Relapse
  • Recurrence
  • Inflammatory bowel disease
  • Precipitating factors

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