P0932 - The Impact of Alcohol Consumption on Developing Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Arpita Jajoo, MD¹, Aasna Shah, DO², Neha Shah, MPH, RD³, Mason Eghbali, MD⁴, Isha Maniyar, BS⁵, Alessia Giusti, ⁶, Christina Fasulo, MS⁵, Jacob White, ⁷, Alyssa Parian, MD⁸, Berkeley Limketkai, MD, PhD^5
1Johns Hopkins University School of Medicine, Baltimore, MD; ²University of Nevada, Las Vegas, NV; ³University of California San Francisco, San Francisco, CA; ⁴George Washington University Hospital, Washington, DC; ⁵University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA; ⁶University of California Los Angeles, Los Angeles, CA; ⁷Johns Hopkins University, Baltimore, MD; ⁸The Johns Hopkins Hospital, Baltimore, MD

Introduction: The effects of alcohol on the risk of developing inflammatory bowel disease (IBD) are not clearly established. A systematic review from 2019 found no significant association between alcohol intake and disease onset, but identified it as a contributor to intestinal inflammation. Since then, multiple prospective studies have evaluated this correlation. The aim of this systematic review and meta-analysis is to clarify the role alcohol consumption plays in the onset of IBD.

Methods: A library informationist designed the search query and retrieved 7308 relevant articles (5225 after deduplication) from Embase, Medline, and Web of Science. Two independent reviewers screened the titles, abstracts, and full text articles to include prospective studies that collected data on alcohol intake prior to diagnosis of Crohn’s disease (CD) or ulcerative colitis (UC). Meta-analyses estimated risk ratios (RR) with 95% confidence intervals (CI) using random effects models. Where raw numbers of cases and controls were unavailable, studies’ reported multivariable regression estimates were used. Sensitivity analyses were performed only using multivariable regression estimates to derive pooled RRs.

Results: Twelve studies prospectively assessed alcohol intake prior to IBD onset in 10 cohorts (EPIC-IBD, Faroese CHEF, Health Professionals Follow-up Study, Nurses Health Studies I and II, NutriNet-Santé, LifeLines, PURE, UK Biobank, and Vasterbotten Intervention Project), of which 7 reported data amenable to meta-analysis. Pooled analysis showed a significant association between alcohol consumption and IBD development (RR 2.24 [95% CI 1.49-3.38], n=407,326, 3 studies) (Figure 1). Stratified analysis corroborated the association for CD (RR 1.85 [95% CI 1.11, 3.09], n=1,007,623, 5 studies) (Figure 2) and UC (RR 1.42 [95% CI 1.04-1.94], n=1,015,311, 7 studies) (Figure 3). In sensitivity analyses using only multivariable adjusted data, alcohol remained significantly associated with IBD risk, but not CD or UC risk. There was significant heterogeneity among all groups analyzed.

Discussion: Alcohol consumption was associated with an increased risk of developing IBD. The diminished significance of multivariate analysis suggests additional factors, such as other substance use and body mass index, may interact with alcohol’s effects on IBD onset. While further research is warranted to elucidate confounding factors, current data suggests that reducing alcohol intake may decrease risk of IBD.



Disclosures:


Arpita Jajoo, MD¹, Aasna Shah, DO², Neha Shah, MPH, RD³, Mason Eghbali, MD⁴, Isha Maniyar, BS⁵, Alessia Giusti, ⁶, Christina Fasulo, MS⁵, Jacob White, ⁷, Alyssa Parian, MD⁸, Berkeley Limketkai, MD, PhD⁵. P0932 - The Impact of Alcohol Consumption on Developing Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.