Risk Factors of Ulcerative Colitis in Northwest India: A Hospital-based Case–control Study

Introduction: Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) with a rising prevalence in developing countries, including India. While most studies on risk factors of UC originate from Western populations, limited data exist for the Indian population, particularly in Rajasthan. This study aimed to identify key dietary, lifestyle, and environmental risk factors associated with UC in Central Rajasthan and to compare their distribution between urban and rural populations. Materials and Methods: A hospital-based case–control study was conducted at Jawaharlal Nehru Hospital, Ajmer, including 85 patients with UC and 85 age- and sex-matched healthy controls without gastrointestinal disorders. Data were collected using a structured questionnaire assessing demographic, dietary, lifestyle, and environmental parameters. Associations between risk factors and UC were analyzed using Chi-square tests and logistic regression. Variables with P < 0.10 in univariate analysis were entered into multivariate logistic regression to determine independent predictors. Results: Nonvegetarian diet (adjusted odds ratio [aOR] 3.95, 95% confidence interval [CI] 1.85–8.42, P = 0.001), family history of IBD (aOR 3.21, 95% CI 1.10–9.34, P = 0.032), and migration from rural to urban areas (aOR 4.10, 95% CI 1.95–8.62, P < 0.001) were independent risk factors for UC. High fiber intake (aOR 0.46, P = 0.018) and smoking (aOR 0.29, P = 0.005) were protective. The proportion of urban and rural residents did not differ significantly between cases and controls. Conclusion: Key risk factors for UC in Central Rajasthan include a nonvegetarian diet, low fiber intake, family history of IBD, and migration from rural to urban settings. The findings underscore the impact of dietary transition and environmental change on the pathogenesis of UC. Targeted public-health strategies promoting fiber-rich diets and lifestyle awareness may aid in disease prevention.