Ulcerative Colitis Resource Center

Ulcerative Colitis Resource Center

Disclosures: Niccum reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
September 23, 2021
2 min read

Alcohol consumption may increase risk for microscopic colitis

Disclosures: Niccum reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Alcohol consumption increased the risk for microscopic colitis, according to a study published in Inflammatory Bowel Disease.

“A few dietary factors have been studied, but none have yet been conclusively associated with risk of [microscopic colitis (MC)],” Blake Niccum, MD, of the department of internal medicine at Massachusetts General Hospital in Boston, and colleagues wrote. “Specifically, several studies have investigated whether alcohol intake increases the risk of MC, but these studies have yielded conflicting results and been limited by a combination of small sample sizes, failure to control for known risk factors for MC, a lack of detailed data on amounts and types of alcohol use and an inability to prospectively ascertain other lifestyle factors and diagnoses of MC.”

The prospective cohort study included 209,902 U.S. women nurses (mean age, 45.5 years; 93.6% white; 74.7% postmenopausal) enrolled in the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII). Data were collected from 1986 to 2016 for the NHS and 1991 to 2017 for the NHSII. Follow-up from baseline was once every 4 years. Investigators used histopathology data to diagnose patients with MC.

Investigators confirmed 352 incident cases of MC over 4,994,324 person-years. Niccum, Hamed Khalili, MD, MPH, and colleagues noted higher alcohol consumption correlated with an increased risk for MC (Ptrend < .001).

Compared with those who do not consume alcohol, results showed the adjusted hazard ratios of MC were 1.2 (95% CI, 0.86-1.67) for consumers of 0.1 g to 4.9 g per day of alcohol, 1.90 (95% CI, 1.34-2.71) for consumers of 5 g to 14.9 g per day, and 2.31 (95% CI, 1.54-3.46) for consumers of 15 g per day or more.

According to researchers, correlations were consistent in the histologic subtypes of collagenous and lymphocytic colitis. The risk based on every two servings a week was strongest with consumption of wine (aHR = 1.08; 95% CI, 1.04-1.12) as compared with beer (aHR = 1.01; 95% CI, 0.91-1.12) or liquor (aHR = 1; 95% CI, 0.92-1.09), after researchers stratified by alcohol type.

“The finding of our study primarily suggest that higher alcohol consumption may be linked to increased risk of microscopic colitis,” Khalili, from Massachusetts General Hospital, Clinical Translational Epidemiology Unit, told Healio Gastroenterology. “It’s an interesting study because many patients ask about lifestyle and dietary modifications that may help with the disease. Although, we did not study the impact of alcohol cessation on disease activity, our results suggest that this could be a very promising area worth studying in the future. I think it’s premature to formally recommend avoiding alcohol, particularly wine in patients with established microscopic colitis.”