{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T06:51:18Z","timestamp":1781765478786,"version":"3.54.5"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T00:00:00Z","timestamp":1519344000000},"content-version":"am","delay-in-days":365,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#am"},{"start":{"date-parts":[[2017,2,23]],"date-time":"2017-02-23T00:00:00Z","timestamp":1487808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000182","name":"Medical Research and Materiel Command","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000182","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["R0879D"],"award-info":[{"award-number":["R0879D"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Crohn's disease (<jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>) and ulcerative colitis (<jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>) are two pathotypes of inflammatory bowel disease (<jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content>) with unique pathology, risk factors and significant morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To estimate incidence and identify <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> risk factors in a <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> military population, a healthy subset of the <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> population, using information from the Millennium Cohort Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Incident <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> was identified from medical encounters from 2001 to 2009 or by self\u2010report. Our primary risk factor of interest, infectious gastroenteritis, was identified from medical encounters and self\u2010reported post\u2010deployment health assessments. Other potential risk factors were assessed using self\u2010reported survey responses and military personnel files. Hazard ratios were estimated using Cox proportional hazards analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We estimated 23.2 and 21.9 diagnoses per 100 000 person\u2010years, respectively, for <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>. For <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>, significant risk factors included [adjusted hazard ratio (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>), 95% confidence interval]: current smoking (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>: 2.7, 1.4\u20135.1), two life stressors (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>: 2.8, 1.4\u20135.6) and prior irritable bowel syndrome (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>: 4.7, 1.5\u201315.2). There was no significant association with prior infectious gastroenteritis. There was an apparent dose\u2013response relationship between <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content> risk and an increasing number of life stressors. In addition, antecedent infectious gastroenteritis was associated with almost a three\u2010fold increase in <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content> risk (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>: 2.9, 1.4\u20136.0). Moderate alcohol consumption (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>: 0.4, 0.2\u20130.6) was associated with lower UC risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Stressful conditions and the high risk of infectious gastroenteritis in deployment operations may play a role in the development of <jats:styled-content style=\"fixed-case\">IBD<\/jats:styled-content> in military populations. However, observed differences in risk factors for <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content> warrant further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13991","type":"journal-article","created":{"date-parts":[[2017,2,23]],"date-time":"2017-02-23T11:33:20Z","timestamp":1487849600000},"page":"1115-1127","source":"Crossref","is-referenced-by-count":36,"title":["Epidemiology of inflammatory bowel disease among participants of the Millennium Cohort: incidence, deployment\u2010related risk factors, and antecedent episodes of infectious gastroenteritis"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7258-1690","authenticated-orcid":false,"given":"C. 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J.","family":"Boyko","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Puget Sound Health Care System Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Gackstetter","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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