{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:45:08Z","timestamp":1792457108811,"version":"4.5.0"},"reference-count":112,"publisher":"Korean Association of Internal Medicine","issue":"2","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["kjim.org"],"crossmark-restriction":true},"short-container-title":["Korean J Intern Med"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:p>Inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease, are distinct chronic immune-mediated intestinal inflammatory disorders. The pathogenesis of IBD is complex and involves a combination of genetic and environmental factors, the gut microbiome, and the host immune system. Despite significant progress in identifying the genetic factors of IBD, the increasing IBD incidence in recent decades, along with findings from immigrant and twin studies, suggest the involvement of environmental factors on IBD susceptibility. In this review, we summarize various up-to-date environmental factors, including early-life influences; diet, food, and nutritional exposures; urbanization and air pollution; smoking; appendectomy; medications; psychological stress; sleep; and latitude and geography.<\/jats:p>","DOI":"10.3904\/kjim.2025.083","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T07:33:22Z","timestamp":1764833602000},"page":"186-196","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The epidemiology of inflammatory bowel disease: exploring the impacts of environmental factors"],"prefix":"10.3904","volume":"41","author":[{"given":"Jihye","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2282-8904","authenticated-orcid":true,"given":"Jae Hee","family":"Cheon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2270","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/7247238"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2023.00080"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra2002697"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3760"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2019.09.004"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2018.03.023"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2023.04.003"},{"key":"ref8","first-page":"17","volume-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","year":"2020"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2021.62.2.99"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1136\/gut.29.7.990"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.312.7023.95"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5085(03)00385-8"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.299.6710.1259"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2024.053"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-68599-x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-13014-7"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21805"},{"key":"ref18","first-page":"1217","volume-title":"Mode of delivery and risk of inflammatory bowel disease in the offspring: systematic review and meta-analysis of observational studies","author":"Bruce","year":"2014"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-020-06204-7"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.08.005"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.07.014"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3390\/nu15245103"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1111\/apt.14291"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/apt.18358"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(20)30267-3"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16751"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100884"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12910"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2024.100219"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i3.895"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.3390\/nu15143114"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2021.758518"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnutbio.2022.109254"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aay6218"},{"key":"ref35","first-page":"2013","volume-title":"Carbohydrate intake in the etiology of Crohn\u2019s disease and ulcerative colitis","author":"Chan","year":"2014"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2021.707795"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.3390\/biom13060905"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1038\/s41419-024-06456-5"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2015.34"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-305304"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2024.00001"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjac054"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.advnut.2023.05.008"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2016.181"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1097\/mib.0000000000000283"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.453"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2024.00049"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1017\/s0714980812000104"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1038\/nature10758"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjae053"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-020-00360-x"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.3402\/iee.v5.27060"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-018-0003-z"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.04.007"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230x-12-51"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjv003"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2023.100259"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2023.169416"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2024-332523"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.289.6450.954"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2014.02.002"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.00074"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2001.23231"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.196"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.284.6330.1706"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i22.2740"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1097\/mib.0000000000000018"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.3780050202"},{"key":"ref69","first-page":"85","volume-title":"Colonic mucus, smoking and ulcerative colitis","author":"Pullan","year":"1996"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.5152\/tjg.2023.22515"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00235"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.1016\/j.smim.2018.02.005"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.3904\/kjim.2024.019"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2003.50021"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinre.2023.102090"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.17235\/reed.2016.4176\/2015"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izac127"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00774-3"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.1097\/00054725-200207000-00007"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1097\/meg.0000000000000915"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16647"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-015-0372-y"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.3390\/ph3041084"},{"key":"ref84","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001932"},{"key":"ref85","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04784.x"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-5-201203060-00007"},{"key":"ref87","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i11.1827"},{"key":"ref88","first-page":"599","volume-title":"Coxib\u2019s safety in patients with inflammatory bowel diseases: a meta- analysis","author":"Ribaldone","year":"2015"},{"key":"ref89","doi-asserted-by":"publisher","DOI":"10.1038\/onc.2009.421"},{"key":"ref90","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12285651"},{"key":"ref91","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.29825"},{"key":"ref92","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v6.i7.142"},{"key":"ref93","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.124"},{"key":"ref94","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.07.042"},{"key":"ref95","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.064261"},{"key":"ref96","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2023.05.001"},{"key":"ref97","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.1016578"},{"key":"ref98","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(19)30089-5"},{"key":"ref99","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldab010"},{"key":"ref100","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-019-0190-z"},{"key":"ref101","doi-asserted-by":"publisher","DOI":"10.1038\/srep35405"},{"key":"ref102","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-59314-7"},{"key":"ref103","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2023.00028"},{"key":"ref104","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2023.00193"},{"key":"ref105","doi-asserted-by":"publisher","DOI":"10.1136\/gut.39.5.690"},{"key":"ref106","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(91)90594-b"},{"key":"ref107","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.06.024"},{"key":"ref108","doi-asserted-by":"publisher","DOI":"10.1097\/01.mib.0000206540.38834.8c"},{"key":"ref109","doi-asserted-by":"publisher","DOI":"10.3390\/nu2050482"},{"key":"ref110","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.180.5.3065"},{"key":"ref111","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013477"},{"key":"ref112","doi-asserted-by":"publisher","DOI":"10.1159\/000442932"}],"container-title":["The Korean Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/kjim.org\/upload\/kjim-2025-083.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2025.083","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/upload\/kjim-2025-083.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:56:09Z","timestamp":1774932969000},"score":1,"resource":{"primary":{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2025.083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,1]]},"references-count":112,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"URL":"https:\/\/doi.org\/10.3904\/kjim.2025.083","relation":{},"ISSN":["1226-3303","2005-6648"],"issn-type":[{"value":"1226-3303","type":"print"},{"value":"2005-6648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,1]]},"assertion":[{"value":"2025-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-04","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}