The Association of Water and Inflammatory Bowel Disease 2806

• Published in: The American journal of gastroenterology Vol. 113; no. Supplement; pp. S1554 - S1555
• Main Authors: Sarao, Manbeer S., Burla, Kiran, Singh, Pratiksha, Tadepalli, Satish, Wert, Maci L., Nookala, Vinod
• Format: Journal Article
• Language: English
• Published: New York Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins 01.10.2018
• Subjects: Drinking water; Gastroenterology; Inflammatory bowel disease; Water treatment; United States > US
• ISSN: 0002-9270; 1572-0241
• DOI: 10.14309/00000434-201810001-02805

Introduction: One of the theories regarding the development of Inflammatory Bowel Disease (IBD) is a dysregulated immune response to natural gut flora in genetically predisposed individuals. The quality and content of the drinking water (both organic and inorganic components) are significant factors in this dysregulation. Several studies have linked drinking water to IBD forming a basis for further studies exploring water as a factor for IBD triggers. This investigation aimed to study the relation between the quantity, kind and source of water and the use of water treatment devices with incidence rates of IBD using the data from National Health and Nutrition Examination Survey (NHANES). Methods: The NHANES survey is conducted by the Centers for Disease Control and Prevention (CDC) along with the National Center for Health Statistics (NCHS). The eligible sample in our study included U.S. adults aged 20-69 years old. There were no exclusions. A total of 5,106 individuals were included in the survey during 2009-2010. The primary outcome was an association between the amount of water consumed and IBD and secondary was the effect of the amount, kind, source of water or use of water treatment devices on the frequency of IBD. Results: Out of 5,106 individuals selected from the years 2009-2010, 53 had Ulcerative Colitis, and 11 had Crohns disease (35 and ten confirmed by colonoscopy, respectively). Our study showed that there was no significant association between the quantity or the source of water and presence or absence of IBD. In our study, cases of IBD were more in the group that drank spring water and did not drink tap water than the group that drank community supply or well or rain cistern water (p=0.9636). Our study also shows that the cases of IBD were more in the group that used water treatment devices than the one which did not (p=0.0803). Conclusion: Previous studies seeking an association between water and its components (organic and inorganic) have shown correlations with iron content, pH, and coliform bacteria. To our knowledge, no other population-based study in the US exploring this association has been published in the literature. Our research shows that there is no significant association between water content and quality to IBD, but there were higher numbers of IBD patients in the group which used water treatment devices and did not drink tap water. Owing to limited data, our study can be treated as a step towards future more extensive studies with sufficient power.