Why does oral disease increase the risk of ulcerative colitis?

Post by Master, Doctor Mai Vien Phuong - Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Ulcerative colitis is associated with reduced microbial diversity and depletion of Bacteroidetes, Firmicutes in the gastrointestinal tract. Disturbances in gut microbiota in IBD, particularly ulcerative colitis, are associated with changes in the salivary microbiome. Therefore, oral hygiene and biofilm may affect pathogens.

This population-based cohort study of approximately 10 million people reported that oral conditions such as periodontitis significantly increased the risk of ulcerative colitis, but not Crohn's disease, compared with those without .
The effect of periodontitis on the risk of developing ulcerative colitis is prominent, especially in elderly men who smoke, drink alcohol, and engage in little physical activity. In particular, current smoking and the presence of periodontitis have a synergistic effect on the occurrence of ulcerative colitis in the elderly.
2. Bacterial disturbances in the oral and intestinal environment influence the pathogenesis of ulcerative colitis The role of the gut microbiota is crucial in the pathogenesis of irritable bowel syndrome (Irritable Bowel Syndrome). IBD) in terms of nutrition, host immune response and defense.
Ulcerative colitis is associated with reduced microbial diversity and depletion of Bacteroidetes, Firmicutes in the gastrointestinal tract. Disturbances in gut microbiota in IBD, particularly ulcerative colitis, are associated with changes in the salivary microbiome. Therefore, oral hygiene and biofilm can influence pathogens.
In contrast, the interactions between the oral microbiome and the development of enteritis in patients with Crohn's disease are very weak. In a recent population-based cohort study in Sweden, dental plaque was negatively associated with a 68% reduction in the risk of Crohn's disease. The dynamic effects of oral hygiene on dysbiosis and chronic inflammation in the gastrointestinal tract need to be elucidated in further studies.
3. Risk group for periodontitis-associated ulcerative colitis The authors determined that the risk groups for periodontitis-associated ulcerative colitis were the elderly, men, alcohol drinkers, and smokers. current leaves and reduced physical activity.
Smoking and smoking cessation are not associated with the course of ulcerative colitis. Recent studies have demonstrated a dose-response relationship between quitting smoking and the risk of developing ulcerative colitis. Consistent with previous results, ex-smokers had the highest risk of developing ulcerative colitis, regardless of the presence of periodontitis and age in this study. In contrast, the impact of current smoking on the prevention of ulcerative colitis is still controversial depending on subgroups such as ethnicity and sex.

4. Periodontitis and smoking increase the risk of developing ulcerative colitis in the elderly. Interestingly, the comparison of the risk of developing ulcerative colitis in the elderly tends to be clearer than in those smoking is more present in former smokers, suggesting that the synergistic effect of periodontitis and smoking increases the risk of onset of ulcerative colitis in the elderly.
Smoking causes changes in both gut and oral microbial composition, which may play an important role, as an environmental cause of ulcerative colitis through dysbiosis of the oral cavity. and intestines. Smoking affects microbial diversity and composition, leading to a decrease in Proteobacteria, Bacteroidetes and an increase in Firmicutes. An infectious denticola treponema is often detected in current smokers with periodontal disease. Further research is needed to determine the combined effect of smoking and periodontitis on the pathogenesis of elderly-onset ulcerative colitis on oral dysbiosis.
5. Age of disease onset The incidence of ulcerative colitis shows a bimodal distribution in the age of onset, and the prevalence in the elderly is closely related to the environmental etiology of inflammation ulcerative colitis. Surprisingly, the steady-state age-specific incidence of ulcerative colitis was between the ages of 20 and 60 with the highest prevalence in men aged 60 years in a 30-year follow-up epidemiological study. recently from Korea. Consistent evidence in former smokers regarding the risk of developing ulcerative colitis, the harmful synergistic effects of current smoking, and periodontitis in the elderly provide important evidence. to explain the role of environmental causes in the complex pathophysiology of elderly-onset ulcerative colitis.
In summary, oral diseases such as periodontitis were significantly associated with the risk of ulcerative colitis but not Crohn's disease. Smoking is now a predisposing factor for periodontitis on the occurrence of ulcerative colitis in the elderly. These findings suggest that smoking associated with periodontitis are potential risk factors for older-onset ulcerative colitis.

References: Kang EA, Chun J, Kim JH, Han K, Soh H, Park S, Hong SW, Moon JM, Lee J, Lee HJ, Park JB, Im JP, Kim JS. Periodontitis combined with smoking increases risk of the ulcerative colitis: A national cohort study. World J Gastroenterol 2020; 26(37): 5661-5672 [PMID: 33088159 DOI: 10.3748/wjg.v26.i37.5661]