Which of the following factors is believed to cause ulcerative colitis?
A. Acidic diet
B. Altered immunity
C. Chronic constipation
D. Emotional stress
Correct Answer: B. Altered immunity
Several theories exist regarding the cause of ulcerative colitis. One suggests altered immunity as the cause based on the extraintestinal characteristics of the disease, such as peripheral arthritis and cholangitis. Although there is little evidence to support this, it has been postulated that alterations in the composition of the gut microbiota and defects in mucosal immunity could lead to ulcerative colitis. Autoimmunity may also play an important role in the etiology of ulcerative colitis.
Option A: Diet has no effect on the development of ulcerative colitis. The specific cause of inflammatory bowel disease is not known. There seems to be a primary genetic component since the most important independent risk factor is a family history of the disease (8% to 14% of patients).
Option C: Chronic constipation does not affect the development of ulcerative colitis. A first-degree relative of a patient with ulcerative colitis has a four times higher risk of developing the disease. Additionally, ulcerative colitis has a higher incidence in Jewish populations than other ethnicities.
Option D: Emotional stress can exacerbate the attacks but isn’t believed to be the primary cause. Some evidence suggests that smoking may be protective but so far no one has been able to confirm a direct relationship between the two.
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