{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:33:26Z","timestamp":1790033606737,"version":"4.0.1"},"reference-count":135,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:00:00Z","timestamp":1633651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Inflammatory bowel disease (IBD) is a chronic and potentially devastating condition of the digestive tract which is exemplified by increasing prevalence worldwide, byzantine pathogenesis with a poorly defined role of the environmental factors, and complex clinical demonstration. As a systemic disease, IBD may progress with a wide spectrum of extraintestinal manifestations (EMs) and comorbidities affecting different organs and systems, from anaemia, undernutrition, and cancer to those which are often neglected like anxiety and depression. Evolving IBD epidemiology and changing environment are reflected by an expanding list of IBD-related comorbidities. In contrast to the well-established role of smoking the connection between alcohol and IBD is still debatable on many levels, from pathogenesis to complications. Furthermore, little is known about narcotics use in IBD patients, even if there are obvious factors that may predispose them to narcotics as well as alcohol misuse. Last but not least, the question arises what is the prevalence of eating disorders in IBD. In our paper, we aimed to discuss the current knowledge on alcohol and drugs misuse and eating disorders as emerging extraintestinal comorbidities in IBD.<\/jats:p>","DOI":"10.3390\/jcm10194623","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T21:23:25Z","timestamp":1633901005000},"page":"4623","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Emerging Comorbidities in Inflammatory Bowel Disease: Eating Disorders, Alcohol and Narcotics Misuse"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2190-3754","authenticated-orcid":false,"given":"Pawe\u0142","family":"Ku\u017anicki","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3650-9311","authenticated-orcid":false,"given":"Katarzyna","family":"Neubauer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Division of Dietetics, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/ecco-jcc\/jjx008","article-title":"Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: Definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders","volume":"11","author":"Magro","year":"2017","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/ecco-jcc\/jjw168","article-title":"3rd European evidence-based consensus on the diagnosis and management of Crohn\u2019s disease 2016: Part 1: Diagnosis and medical management","volume":"11","author":"Dignass","year":"2017","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1097\/MOG.0000000000000364","article-title":"Etiopathogenesis of inflammatory bowel disease: Today and tomorrow","volume":"33","year":"2017","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"584278","DOI":"10.3389\/fped.2020.584278","article-title":"Spanish Pediatric Inflammatory Bowel Disease Diagnostic Delay Registry: SPIDER Study From Sociedad Espa\u00f1ola de Gastroenterolog\u00eda, Hepatolog\u00eda y Nutrici\u00f3n Pedi\u00e1trica","volume":"8","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1093\/ecco-jcc\/jjx041","article-title":"The time course of diagnostic delay in inflammatory bowel disease over the last sixty years: An Italian multicentre study","volume":"11","author":"Cantoro","year":"2017","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1053\/j.gastro.2020.08.064","article-title":"Effects of Race and Ethnicity on Diagnosis and Management of Inflammatory Bowel Diseases","volume":"160","author":"Barnes","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S2468-1253(19)30333-4","article-title":"The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"5","author":"Alatab","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Ling, F., Tu, L., Li, J., Chen, Y., Xu, M., and Zhu, L. (2021). Psychological aspect of patients with inflammatory bowel disease, which may be related to the quality of life, sleep and disease characteristics. Scand. J. Gastroenterol., 1\u20139.","DOI":"10.1080\/00365521.2021.1966093"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Larussa, T., Flauti, D., Abenavoli, L., Boccuto, L., Suraci, E., Marasco, R., Imeneo, M., and Luzza, F. (2020). The Reality of Patient-Reported Outcomes of Health-Related Quality of Life in an Italian Cohort of Patients with Inflammatory Bowel Disease: Results from a Cross-Sectional Study. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082416"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Jones, J.L., Nguyen, G.C., Benchimol, E.I., Bernstein, C.N., Bitton, A., Kaplan, G.G., Murthy, S.K., Lee, K., Cooke-Lauder, J., and Otley, A.R. (2019). The Impact of Inflammatory Bowel Disease in Canada 2018: Quality of Life. J. Can. Assoc. Gastroenterol., 2.","DOI":"10.1093\/jcag\/gwy048"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1093\/ibd\/izaa144","article-title":"The Effect of Psychotherapy on Quality of Life in IBD Patients: A Systematic Review","volume":"27","author":"Paulides","year":"2021","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_12","first-page":"165","article-title":"Inflammatory bowel diseases and work disability: A systematic review of predictive factors","volume":"25","author":"Leso","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1093\/jcag\/gwy050","article-title":"The Impact of Inflammatory Bowel Disease in Canada 2018: Indirect Costs of IBD Care","volume":"2","author":"Kuenzig","year":"2019","journal-title":"J. Can. Assoc. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/apt.16445","article-title":"Systematic review: Societal cost of illness of inflammatory bowel disease is increasing due to biologics and varies between continents","volume":"54","author":"Visser","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1093\/jcag\/gwy055","article-title":"The Impact of Inflammatory Bowel Disease in Canada 2018: Direct Costs and Health Services Utilization","volume":"2","author":"Kuenzig","year":"2019","journal-title":"J. Can. Assoc. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1159\/000447283","article-title":"The Search for Causative Environmental Factors in Inflammatory Bowel Disease","volume":"34","author":"Rogler","year":"2016","journal-title":"Dig. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1097\/MPG.0000000000002908","article-title":"The Gut Microbiome and the Triple Environmental Hit Concept of Inflammatory Bowel Disease Pathogenesis","volume":"71","author":"Kellermayer","year":"2020","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1136\/gutjnl-2020-322129","article-title":"Emerging treatment options for extraintestinal manifestations in IBD","volume":"70","author":"Greuter","year":"2021","journal-title":"Gut"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S2468-1253(19)30173-6","article-title":"Comorbidities in inflammatory bowel disease: A call for action","volume":"4","author":"Argollo","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1159\/000503099","article-title":"Management of the Elderly Inflammatory Bowel Disease Patient","volume":"101","author":"Hruz","year":"2020","journal-title":"Digestion"},{"key":"ref_21","first-page":"1505","article-title":"The emerging role of mood disorders in inflammatory bowel diseases","volume":"29","author":"Neubauer","year":"2021","journal-title":"Adv. Clin. Exp. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.drugalcdep.2015.05.031","article-title":"Prevalence of comorbid substance use, anxiety and mood disorders in epidemiological surveys, 1990-2014: A systematic review and meta-analysis","volume":"154","author":"Lai","year":"2015","journal-title":"Drug Alcohol Depend."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Wark, G., Samocha-Bonet, D., Ghaly, S., and Danta, M. (2021). The role of diet in the pathogenesis and management of inflammatory bowel disease: A review. Nutrients, 13.","DOI":"10.3390\/nu13010135"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1038\/nrgastro.2017.110","article-title":"The IBD interactome: An integrated view of aetiology, pathogenesis and therapy","volume":"14","author":"Fiocchi","year":"2017","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1053\/j.gastro.2020.09.056","article-title":"Inflammatory Bowel Diseases (IBD) and the Microbiome\u2014Searching the Crime Scene for Clues","volume":"160","author":"Lee","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1016\/S0140-6736(20)30059-3","article-title":"Eating disorders","volume":"395","author":"Treasure","year":"2020","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Sarmiento, C., and Lau, C. (2020). Diagnostic and Statistical Manual of Mental Disorders. The Wiley Encyclopedia of Personality and Individual Differences, John Wiley & Sons Ltd.. [5th ed.]. DSM-5.","DOI":"10.1002\/9781119547174.ch198"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3823","DOI":"10.3748\/wjg.v25.i28.3823","article-title":"Systematic review of nutrition screening and assessment in inflammatory bowel disease","volume":"25","author":"Li","year":"2019","journal-title":"World J. Gastroenterol."},{"key":"ref_29","first-page":"884","article-title":"Erratum: A Cross-Sectional Study on Malnutrition in Inflammatory Bowel Disease: Is There a Difference Based on Pediatric or Adult Age Grouping?","volume":"37","author":"Marcil","year":"2020","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/j.clnu.2017.03.010","article-title":"Food avoidance in patients with inflammatory bowel disease: What, when and who?","volume":"37","author":"Bergeron","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"345","DOI":"10.2147\/JIR.S174982","article-title":"The role of inflammation in irritable bowel syndrome (IBS)","volume":"11","author":"Ng","year":"2018","journal-title":"J. Inflamm. Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Butler, M.J., Perrini, A.A., and Eckel, L.A. (2021). The role of the gut microbiome, immunity, and neuroinflammation in the pathophysiology of eating disorders. Nutrients, 13.","DOI":"10.3390\/nu13020500"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/srep26752","article-title":"Weight gain in anorexia nervosa does not ameliorate the faecal microbiota, branched chain fatty acid profiles, and gastroin-testinal complaints","volume":"6","author":"Mack","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Moran, G.W., and Thapaliya, G. (2021). The gut\u2013brain axis and its role in controlling eating behavior in intestinal inflammation. Nutrients, 13.","DOI":"10.3390\/nu13030981"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1080\/00365521.2019.1697897","article-title":"The prevalence and risk factors of psychological disorders, malnutrition and quality of life in IBD patients","volume":"54","author":"Cao","year":"2019","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1001\/archgenpsychiatry.2011.22","article-title":"Prevalence and correlates of eating disorders in adolescents: Results from the national comorbidity survey replication adolescent supplement","volume":"68","author":"Swanson","year":"2011","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"68","DOI":"10.14309\/ajg.0000000000001029","article-title":"Assessing for Eating Disorders: A Primer for Gastroenterologists","volume":"116","author":"Werlang","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/S2352-4642(18)30386-9","article-title":"Eating disorders in adolescents with chronic gastrointestinal and endocrine diseases","volume":"3","author":"Avila","year":"2019","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.eurpsy.2003.01.002","article-title":"Anorexia nervosa and Crohn\u2019s disease dual diagnosis: A case study","volume":"18","author":"Bouvard","year":"2003","journal-title":"Eur. Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jpsychores.2017.09.006","article-title":"Inflammatory Bowel Disease and Eating Disorders: A systematized review of comorbidity","volume":"102","author":"Ilzarbe","year":"2017","journal-title":"J. Psychosom. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1001\/jamapediatrics.2019.2662","article-title":"Association of Childhood-Onset Inflammatory Bowel Disease with Risk of Psychiatric Disorders and Suicide Attempt","volume":"173","author":"Butwicka","year":"2019","journal-title":"JAMA Pediatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"S-435","DOI":"10.1016\/S0016-5085(20)31772-8","article-title":"Sa1812 eating disorders in an out-patient academic inflammatory bowel disease practice: Prevalence and provider diagnostic accuracy","volume":"158","author":"Robelin","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Wabich, J., Bellaguarda, E., Joyce, C., Keefer, L., and Kinsinger, S. (2020). Disordered Eating, Body Dissatisfaction, and Psychological Distress in Patients with Inflammatory Bowel Disease (IBD). J. Clin. Psychol. Med. Settings, 27.","DOI":"10.1007\/s10880-020-09710-y"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Marafini, I., Longo, L., Lavasani, D.M., Rossi, R., Salvatori, S., Pianigiani, F., Calabrese, E., Siracusano, A., Di Lorenzo, G., and Monteleone, G. (2020). High Frequency of Undiagnosed Psychiatric Disorders in Inflammatory Bowel Diseases. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051387"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.14309\/01.ajg.0000723016.65507.97","article-title":"P055 Restrictive Eating Symptoms May Persist in Children & Adolescents With Treated IBD: Case Series","volume":"115","author":"Jonathan","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1751-0759-6-4","article-title":"Somatic comorbidity in anorexia nervosa: First results of a 21-year follow-up study on female inpatients","volume":"6","author":"Erdur","year":"2012","journal-title":"Biopsychosoc. Med."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Raevuori, A., Haukka, J., Vaarala, O., Suvisaari, J.M., Gissler, M., Grainger, M., Linna, M.S., and Suokas, J.T. (2014). The increased risk for autoimmune diseases in patients with eating disorders. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0104845"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1002\/eat.22544","article-title":"Coexistence of eating disorders and autoimmune diseases: Record linkage cohort study, UK","volume":"49","author":"Wotton","year":"2016","journal-title":"Int. J. Eat. Disord."},{"key":"ref_49","unstructured":"WHO (2018). Global Status Report on Alcohol and Health 2018, World Health Organization."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3109\/00952990.2015.1102923","article-title":"Underage drinking: Prevalence and correlates of risky drinking measures among youth aged 12\u201320","volume":"42","author":"Richter","year":"2016","journal-title":"Am. J. Drug Alcohol Abuse"},{"key":"ref_51","unstructured":"IARC (2012). Personal Habits and Indoor Combustions. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, IARC."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1200\/JCO.2017.76.1155","article-title":"Alcohol and cancer: A statement of the American society of clinical oncology","volume":"36","author":"LoConte","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1002\/hep.23009","article-title":"Endotoxemia and gut barrier dysfunction in alcoholic liver disease","volume":"50","author":"Rao","year":"2009","journal-title":"Hepatology"},{"key":"ref_54","first-page":"163","article-title":"Alcohol and gut-derived inflammation","volume":"38","author":"Bishehsari","year":"2017","journal-title":"Alcohol Res. Curr. Rev."},{"key":"ref_55","first-page":"97","article-title":"Focus on: Alcohol and the immune system","volume":"33","author":"Molina","year":"2010","journal-title":"Alcohol Res. Health"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1002\/JLB.4MA1217-506R","article-title":"Alcohol enhances symptoms and propensity for infection in inflammatory bowel disease patients and a murine model of DSS-induced colitis","volume":"104","author":"Cannon","year":"2018","journal-title":"J. Leukoc. Biol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1002\/hep.1840130211","article-title":"Circulating tumor necrosis factor, interleukin-1 and interleukin-6 concentrations in chronic alcoholic patients","volume":"13","author":"Khoruts","year":"1991","journal-title":"Hepatology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.4049\/jimmunol.0803206","article-title":"The Opposite Effects of Acute and Chronic Alcohol on Lipopolysaccharide-Induced Inflammation Are Linked to IRAK-M in Human Monocytes","volume":"183","author":"Mandrekar","year":"2009","journal-title":"J. Immunol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1159\/000329403","article-title":"Is moderate red wine consumption safe in inactive inflammatory bowel disease?","volume":"84","author":"Swanson","year":"2011","journal-title":"Digestion"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/01.mcg.0000225644.75651.f1","article-title":"Risk factors for ulcerative colitis in a Chinese population: An age-matched and sex-matched case-control study","volume":"41","author":"Jiang","year":"2007","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1586\/egh.11.29","article-title":"Existing dietary guidelines for Crohns disease and ulcerative colitis","volume":"5","author":"Brown","year":"2011","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Hsu, T.Y., Shih, H.M., Wang, Y.C., Lin, L.C., He, G.Y., Chen, C.Y., Kao, C.H., Chen, C.H., Chen, W.K., and Yang, T.Y. (2016). Effect of alcoholic intoxication on the risk of inflammatory bowel disease: A nationwide retrospective cohort study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0165411"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1038\/ejcn.2016.271","article-title":"No association of alcohol use and the risk of ulcerative colitis or Crohn\u2019s disease: Data from a European Prospective cohort study (EPIC)","volume":"71","author":"Bergmann","year":"2017","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e9070","DOI":"10.1097\/MD.0000000000009070","article-title":"Beverage consumption and risk of ulcerative colitis: Systematic review and meta-analysis of epidemiological studies","volume":"96","author":"Nie","year":"2017","journal-title":"Medicine"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"e15795","DOI":"10.1097\/MD.0000000000015795","article-title":"Beverage intake and risk of Crohn disease: A meta-analysis of 16 epidemiological studies","volume":"98","author":"Yang","year":"2019","journal-title":"Medicine"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.bpg.2017.10.004","article-title":"The role of smoking and alcohol behaviour in the management of inflammatory bowel disease","volume":"31","author":"Khasawneh","year":"2017","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.mrfmmm.2009.09.002","article-title":"Environmental factors in the development of chronic inflammation: A case-control study on risk factors for Crohn\u2019s disease within New Zealand","volume":"690","author":"Han","year":"2010","journal-title":"Mutat. Res. Fundam. Mol. Mech. Mutagen."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1038\/nm.3892","article-title":"Innate lymphoid cells in the initiation, regulation and resolution of inflammation","volume":"21","author":"Sonnenberg","year":"2015","journal-title":"Nat. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1038\/nature06005","article-title":"Unravelling the pathogenesis of inflammatory bowel disease","volume":"448","author":"Xavier","year":"2007","journal-title":"Nature"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1475-2891-4-7","article-title":"Associations between diet and disease activity in ulcerative colitis patients using a novel method of data analysis","volume":"4","author":"Magee","year":"2005","journal-title":"Nutr. J."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1007\/BF02100146","article-title":"Antagonistic Effects of Sulfide and Butyrate on Proliferation of Colonic Mucosa: A Potential Role for These Agents in the Pathogenesis of Ulcerative Colitis","volume":"41","author":"Christl","year":"1996","journal-title":"Dig. Dis. Sci."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1080\/00365520701452241","article-title":"Effects of five different alcoholic drinks on patients with Crohn\u2019s disease","volume":"42","author":"Hey","year":"2007","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_73","first-page":"649","article-title":"Alcohol and narcotics use in inflammatory bowel disease","volume":"31","author":"Mantzouranis","year":"2018","journal-title":"Ann. Gastroenterol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1007\/s00384-007-0332-9","article-title":"Crohn\u2019s disease: A patient\u2019s perspective","volume":"22","author":"Zutshi","year":"2007","journal-title":"Int. J. Colorectal Dis."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Guida, L., Di Giorgio, F.M., Busacca, A., Carrozza, L., Ciminnisi, S., Almasio, P.L., Di Marco, V., and Cappello, M. (2021). Perception of the role of food and dietary modifications in patients with inflammatory bowel disease: Impact on lifestyle. Nutrients, 13.","DOI":"10.3390\/nu13030759"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.alcohol.2009.10.019","article-title":"Pattern of alcohol consumption and its effect on gastrointestinal symptoms in inflammatory bowel disease","volume":"44","author":"Swanson","year":"2010","journal-title":"Alcohol"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.mrfmmm.2010.01.020","article-title":"Dietary factors in chronic inflammation: Food tolerances and intolerances of a New Zealand Caucasian Crohn\u2019s disease population","volume":"690","author":"Triggs","year":"2010","journal-title":"Mutat. Res. Fundam. Mol. Mech. Mutagen."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Zallot, C., Quilliot, D., Chevaux, J.B., Peyrin-Biroulet, C., Gu\u00e9ant-Rodriguez, R.M., Freling, E., Collet-Fenetrier, B., Williet, N., Ziegler, O., and Bigard, M.A. (2013). Dietary beliefs and behavior among inflammatory bowel disease patients. Inflamm. Bowel Dis., 19.","DOI":"10.1002\/ibd.22965"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1007\/s10620-012-2373-3","article-title":"Dietary patterns and self-reported associations of diet with symptoms of inflammatory bowel disease","volume":"58","author":"Cohen","year":"2013","journal-title":"Dig. Dis. Sci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1097\/MIB.0000000000000585","article-title":"Dietary Practices and Beliefs in Patients with Inflammatory Bowel Disease","volume":"22","author":"Limdi","year":"2016","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Crooks, B., Misra, R., Arebi, N., Kok, K., Brookes, M.J., McLaughlin, J., and Limdi, J.K. (2021). The dietary practices and beliefs of people living with older-onset inflammatory bowel disease. Eur. J. Gastroenterol. Hepatol.","DOI":"10.1097\/MEG.0000000000002130"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Crooks, B., Misra, R., Arebi, N., Kok, K., Brookes, M.J., McLaughlin, J., and Limdi, J.K. (2021). The dietary practices and beliefs of British South Asian people living with inflammatory bowel disease: A multicenter study from the United Kingdom. Intest. Res.","DOI":"10.1097\/MEG.0000000000002130"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/MEG.0000000000001911","article-title":"The dietary practices and beliefs of people living with inactive ulcerative colitis","volume":"33","author":"Crooks","year":"2021","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1177\/0148607114549254","article-title":"What are adults with inflammatory bowel disease (IBD) eating? A closer look at the dietary habits of a population-based Canadian IBD cohort","volume":"40","author":"Vagianos","year":"2016","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1080\/13556210050003702","article-title":"Alcohol-related diarrhea","volume":"5","author":"Chiba","year":"2000","journal-title":"Addict. Biol."},{"key":"ref_86","first-page":"760","article-title":"Ethanol interactions with other cytochrome P450 substrates including drugs, xenobiotics, and carcinogens","volume":"46","author":"Djordjevic","year":"1998","journal-title":"Pathol. Biol."},{"key":"ref_87","first-page":"221","article-title":"Alcohol use in patients with inflammatory bowel disease","volume":"17","author":"Ramos","year":"2021","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_88","first-page":"397","article-title":"Therapeutic uses of metronidazole and its side effects: An update","volume":"23","year":"2019","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijpharm.2008.04.035","article-title":"Impairment of the in vitro drug release behaviour of oral modified release preparations in the presence of alcohol","volume":"360","author":"Fadda","year":"2008","journal-title":"Int. J. Pharm."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1517\/17425255.2012.691166","article-title":"The effects of alcohol on the metabolism and toxicology of anti-psoriasis drugs","volume":"8","author":"Vena","year":"2012","journal-title":"Expert Opin. Drug Metab. Toxicol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"4646","DOI":"10.3748\/wjg.v13.i34.4646","article-title":"Alcohol binging causes peliosis hepatis during azathioprine therapy in crohn\u2019s disease","volume":"13","author":"Elsing","year":"2007","journal-title":"World J. Gastroenterol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1136\/annrheumdis-2016-210629","article-title":"Quantifying the hepatotoxic risk of alcohol consumption in patients with rheumatoid arthritis taking methotrexate","volume":"76","author":"Humphreys","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/0002-9343(91)90667-M","article-title":"Methotrexate and histologic hepatic abnormalities: A meta-analysis","volume":"90","author":"Fye","year":"1991","journal-title":"Am. J. Med."},{"key":"ref_94","first-page":"69","article-title":"Does cytochrome P450 liver isoenzyme induction increase the risk of liver toxicity after paracetamol overdose?","volume":"3","author":"Kalsi","year":"2011","journal-title":"Open Access Emerg. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"527","DOI":"10.5223\/pghn.2019.22.6.527","article-title":"Burden of psychiatric disorders among pediatric and young adults with inflammatory bowel disease: A population-based analysis","volume":"22","author":"Thavamani","year":"2019","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/MPG.0000000000002365","article-title":"Substance Use in Adolescents and Young Adults with Inflammatory Bowel Diseases: An Exploratory Cluster Analysis","volume":"69","author":"Plevinsky","year":"2019","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Ludvigsson, J.F., Ol\u00e9n, O., Larsson, H., Halfvarson, J., Almqvist, C., Lichtenstein, P., and Butwicka, A. (2021). Association Between Inflammatory Bowel Disease and Psychiatric Morbidity and Suicide: A Swedish Nationwide Population-Based Cohort Study With Sibling Comparisons. J. Crohn\u2019s Colitis.","DOI":"10.1093\/ecco-jcc\/jjab039"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1136\/gutjnl-2018-317610","article-title":"Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: A population-based cohort study","volume":"68","author":"Vigod","year":"2019","journal-title":"Gut"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1093\/ibd\/izaa014","article-title":"Prevalence and Risk Factors of Substance Use Disorder in Inflammatory Bowel Disease","volume":"27","author":"Carney","year":"2021","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Brooks, A., Rowse, G., Peach, E., Ryder, A., Narula, P., Corfe, B., Norman, P., and Lobo, A. (2016). OC-087 Frequency of Health Risk Behaviours in Young People With Inflammatory Bowel Disease. Gut.","DOI":"10.1136\/gutjnl-2017-314472.300"},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Cross, R.K., Wilson, K.T., and Binion, D.G. (2005). Narcotic use in patients with Crohn\u2019s disease. Am. J. Gastroenterol.","DOI":"10.1111\/j.1572-0241.2005.00256.x"},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Zeitz, J., Ak, M., Muller-Mottet, S., Scharl, S., Biedermann, L., Fournier, N., Frei, P., Pittet, V., Scharl, M., and Fried, M. (2016). Pain in IBD patients: Very frequent and frequently insufficiently taken into account. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0156666"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/apt.15023","article-title":"Incidence and predictors of new persistent opioid use following inflammatory bowel disease flares treated with oral corticosteroids","volume":"49","author":"Noureldin","year":"2019","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1038\/ajg.2014.230","article-title":"The prevalence and predictors of opioid use in inflammatory bowel disease: A population-based analysis","volume":"109","author":"Targownik","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1136\/gut.2005.080887","article-title":"Mu opioid receptor expression is increased in inflammatory bowel diseases: Implications for homeostatic intestinal inflammation","volume":"55","author":"Philippe","year":"2006","journal-title":"Gut"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1093\/ecco-jcc\/jjy008","article-title":"The effect of low-dose naltrexone on medication in inflammatory bowel disease: A quasi experimental before-and-after prescription database study","volume":"12","author":"Raknes","year":"2018","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12967-018-1427-5","article-title":"Low dose Naltrexone for induction of remission in inflammatory bowel disease patients","volume":"16","author":"Lie","year":"2018","journal-title":"J. Transl. Med."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1097\/MIB.0000000000001152","article-title":"Modified Delphi Process for the Development of Choosing Wisely for Inflammatory Bowel Disease","volume":"23","author":"Nguyen","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s00482-015-0087-0","article-title":"Efficacy, tolerability, and safety of cannabinoids in gastroenterology: A systematic review","volume":"30","author":"Volz","year":"2016","journal-title":"Schmerz"},{"key":"ref_110","doi-asserted-by":"crossref","unstructured":"Kienzl, M., Storr, M., and Schicho, R. (2020). Cannabinoids and Opioids in the Treatment of Inflammatory Bowel Diseases. Clin. Transl. Gastroenterol., 11.","DOI":"10.14309\/ctg.0000000000000120"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.neuropharm.2013.03.029","article-title":"A role for O-1602 and G protein-coupled receptor GPR55 in the control of colonic motility in mice","volume":"71","author":"Li","year":"2013","journal-title":"Neuropharmacology"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41467-018-08051-7","article-title":"Intestinal epithelial N-acylphosphatidylethanolamine phospholipase D links dietary fat to metabolic adaptations in obesity and steatosis","volume":"10","author":"Everard","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"S1588","DOI":"10.14309\/01.ajg.0000601160.51070.23","article-title":"2907 Knowledge and Perception of Gastroenterologists Regarding Medical Marijuana Use in Patients With Inflammatory Bowel Disease","volume":"114","author":"Santiago","year":"2019","journal-title":"Am. J. Gastroenterol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1016\/j.cgh.2013.04.034","article-title":"Cannabis induces a clinical response in patients with crohn\u2019s disease: A prospective placebo-controlled study","volume":"11","author":"Naftali","year":"2013","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Naftali, T., Schleider, L.B.L., Benjaminov, F.S., Konikoff, F.M., Matalon, S.T., and Ringel, Y. (2021). Cannabis is associated with clinical but not endoscopic remission in ulcerative colitis: A randomized controlled trial. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0246871"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1157\/13097468","article-title":"Utilizaci\u00f3n de medicinas alternativas y consumo de drogas por pacientes con enfermedad inflamatoria intestinal","volume":"128","author":"Bernal","year":"2007","journal-title":"Med. Clin."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1097\/MEG.0b013e328349bb4c","article-title":"Cannabis use amongst patients with inflammatory bowel disease","volume":"23","author":"Lal","year":"2011","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"2809","DOI":"10.1097\/01.MIB.0000435851.94391.37","article-title":"Marijuana use patterns among patients with inflammatory bowel disease","volume":"19","author":"Allegretti","year":"2013","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/01.MIB.0000440982.79036.d6","article-title":"Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn\u2019s disease","volume":"20","author":"Storr","year":"2014","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.drugalcdep.2015.08.035","article-title":"Patterns of cannabis use in patients with Inflammatory Bowel Disease: A population based analysis","volume":"156","author":"Weiss","year":"2015","journal-title":"Drug Alcohol Depend."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/MPG.0000000000001474","article-title":"Prevalence and Patterns of Marijuana Use in Young Adults with Inflammatory Bowel Disease","volume":"64","author":"Phatak","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/MPG.0000000000002189","article-title":"Cannabis oil use by adolescents and young adults with inflammatory bowel disease","volume":"68","author":"Hoffenberg","year":"2019","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"otaa015","DOI":"10.1093\/crocol\/otaa015","article-title":"Medicinal cannabis for inflammatory bowel disease: A survey of perspectives, experiences, and current use in australian patients","volume":"360","author":"Benson","year":"2020","journal-title":"Crohn\u2019s Colitis"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1093\/ibd\/izz272","article-title":"Cannabis use in persons with inflammatory bowel disease and vulnerability to substance misuse","volume":"26","author":"Hansen","year":"2020","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.drugpo.2014.07.011","article-title":"Probability and predictors of the cannabis gateway effect: A national study","volume":"26","author":"Jin","year":"2015","journal-title":"Int. J. Drug Policy"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1053\/j.gastro.2016.04.015","article-title":"The Role of the Endocannabinoid System in the Brain\u2013Gut Axis","volume":"151","author":"Sharkey","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_127","doi-asserted-by":"crossref","unstructured":"Jacobs, J.D., Boden, E.K., Lord, J.D., and Chiorean, M.V. (2020). Tu1906 prevalence and association of cannabis use with disease activity in patients with inflammatory bowel disease. Gastroenterology, 158.","DOI":"10.1016\/S0016-5085(20)33693-3"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1007\/s10620-017-4540-z","article-title":"Low-Dose Cannabidiol Is Safe but Not Effective in the Treatment for Crohn\u2019s Disease, a Randomized Controlled Trial","volume":"62","author":"Naftali","year":"2017","journal-title":"Dig. Dis. Sci."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/00004836-198806000-00010","article-title":"Narcotic dependence in inflammatory bowel disease","volume":"10","author":"Kaplan","year":"1988","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1046\/j.1440-1746.2001.02468.x","article-title":"Chronic narcotic use in inflammatory bowel disease patients: Prevalence and clinical characteristics","volume":"16","author":"Edwards","year":"2001","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.cgh.2014.07.057","article-title":"Prevalence of chronic narcotic use among children with inflammatory bowel disease","volume":"13","author":"Buckley","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12876-021-01716-6","article-title":"The incidence and prevalence of inflammatory bowel disease in UK primary care: A retrospective cohort study of the IQVIA Medical Research Database","volume":"21","author":"Freeman","year":"2021","journal-title":"BMC Gastroenterol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"e256","DOI":"10.1016\/j.crohns.2012.10.007","article-title":"High and increasing prevalence of inflammatory bowel disease in Finland with a clear North-South difference","volume":"7","author":"Jussila","year":"2013","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/MEG.0000000000000660","article-title":"Burden of disease and increasing prevalence of inflammatory bowel disease in a population-based cohort in the Netherlands","volume":"28","author":"Rossen","year":"2016","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1093\/ajcn\/nqy342","article-title":"Prevalence of eating disorders over the 2000-2018 period: A systematic literature review","volume":"109","author":"Galmiche","year":"2019","journal-title":"Am. J. Clin. Nutr."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/19\/4623\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:10:42Z","timestamp":1760166642000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/19\/4623"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,8]]},"references-count":135,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["jcm10194623"],"URL":"https:\/\/doi.org\/10.3390\/jcm10194623","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,8]]}}}