PFAS and Ulcerative Colitis: Investigating the Connection

While much attention has been given to PFAS’ links with cancer and metabolic disorders, scientific evidence also suggests that PFAS may also play a significant role in autoimmune diseases – particularly ulcerative colitis (UC).

This article explores the mechanisms by which PFAS exposure may contribute to UC, the epidemiological studies supporting this link, and the broader implications for public health.

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that affects the lining of the colon and rectum, leading to severe digestive distress, immune dysregulation, and increased long-term health risks.

Unlike Crohn’s disease, which can affect any part of the digestive tract, UC is restricted to the large intestine. Symptoms can vary in severity and include:

• Abdominal pain and cramping
• Persistent diarrhea (often with blood or mucus)
• Unintended weight loss
• Chronic fatigue
• Increased risk of colorectal cancer over time

UC is believed to result from a combination of genetic, environmental, and immune system factors. While autoimmune responses and gut microbiome imbalances are key contributors, new research suggests that environmental toxins, including PFAS, could be exacerbating this condition.

The immune system plays a critical role in maintaining gut health. Under normal conditions, immune cells in the intestines help regulate inflammation and prevent overactivation of the body’s defense mechanisms. However, PFAS have been shown to interfere with immune regulation by:

• Altering Cytokine Production: A study published in Environmental Health Perspectives (2016) found that PFAS exposure increases levels of pro-inflammatory cytokines such as IL-6 and TNF-α. These cytokines are already elevated in UC patients, suggesting that PFAS may amplify inflammation in individuals predisposed to the disease.
• Disrupting T-Cell Balance: Research in Toxicological Sciences (2020) indicated that PFAS exposure shifts the balance between regulatory T cells (Tregs) and effector T cells in the gut, leading to immune overactivation and chronic inflammation.
• Suppressing Immunoglobulin A (IgA) Production: IgA is essential for maintaining gut barrier integrity. A study from the Journal of Immunotoxicology (2019) demonstrated that PFAS exposure reduces IgA levels, making the intestinal lining more vulnerable to harmful pathogens and inflammatory damage.

The intestinal epithelium acts as a protective barrier, preventing harmful substances from entering the bloodstream. PFAS have been found to weaken this barrier, increasing intestinal permeability and allowing toxins, bacteria, and inflammatory agents to pass through—a condition commonly referred to as “leaky gut.”

• Epithelial Cell Disruption: A 2021 study in Gastroenterology found that PFAS exposure compromises tight junction proteins in the gut, leading to increased permeability and higher susceptibility to inflammatory damage.
• Mucosal Layer Depletion: PFAS have been shown to disrupt the production of mucus-secreting goblet cells, which are essential for protecting the intestinal lining. When this mucosal barrier is compromised, it increases the likelihood of UC flare-ups and prolonged inflammation.

The gut microbiome consists of trillions of bacteria that play a critical role in digestion, immune modulation, and inflammation control. Studies indicate that PFAS exposure can alter gut microbiota composition, reducing beneficial bacterial populations while promoting harmful strains that exacerbate UC.

• Reduction in Beneficial Bacteria: Research in the International Journal of Environmental Research and Public Health (2022) found that PFAS exposure significantly reduces populations of Lactobacillus and Bifidobacterium, both of which are associated with anti-inflammatory effects and gut health.
• Increase in Pathogenic Bacteria: An increase in pathogenic bacteria such as Escherichia coli has been observed in PFAS-exposed individuals, potentially contributing to chronic inflammation and worsening UC symptoms.

Several large-scale studies have examined the connection between PFAS exposure and UC incidence:

• C8 Health Project (2013): This study analyzed health outcomes in over 69,000 individuals exposed to PFOA (a type of PFAS) in drinking water near DuPont’s plant in West Virginia. Researchers found a significant increase in reported cases of ulcerative colitis among exposed populations compared to unexposed groups.
• NHANES Study (2020): Data from the National Health and Nutrition Examination Survey (NHANES) revealed that individuals with higher PFAS blood levels had a greater likelihood of being diagnosed with inflammatory bowel diseases, including UC.
• Military Personnel Studies: Veterans stationed at PFAS-contaminated military bases have reported higher rates of UC, leading to further investigations into the potential occupational risks of prolonged PFAS exposure.

While PFAS exposure affects broad populations, certain groups face elevated risks of UC:

• Individuals Living Near Contaminated Water Sources: Communities with industrial PFAS pollution have higher UC rates.
• Firefighters and Military Personnel: Due to extensive use of PFAS-containing firefighting foam.
• People with Preexisting Autoimmune Conditions: Those already susceptible to immune dysfunction may experience worsened UC symptoms due to PFAS exposure.

For years, aqueous film-forming foam (AFFF) has been a staple in military, airport, and industrial firefighting operations. However, the PFAS chemicals in AFFF have been linked to a range of health problems, including autoimmune conditions like ulcerative colitis.

Due to mounting scientific evidence, individuals diagnosed with ulcerative colitis after prolonged exposure to AFFF are eligible to pursue legal action.

Learn more about submitting an Ulcerative Colitis claim in the AFFF lawsuit

The AFFF lawsuit is currently accepting claims from individuals who developed ulcerative colitis following repeated exposure to PFAS-containing firefighting foam. Potential claimants may include:

• Firefighters and First Responders who handled AFFF in training exercises and emergency response situations.
• Military veterans and their dependents who drank contaminated water at bases where AFFF was frequently used for fire suppression.
• Airport and Industrial Workers who worked in environments where AFFF was a common safety tool.
• Communities Near Contaminated Sites exposed to PFAS-contaminated water supplies linked to AFFF use.

The lawsuit is part of a larger multi-district litigation (MDL) against chemical manufacturers responsible for producing PFAS-laden AFFF. Plaintiffs are seeking compensation for medical expenses, loss of income, and other damages related to their UC diagnosis.

As more evidence surfaces regarding PFAS’s role in autoimmune diseases, legal experts anticipate continued expansion of claims.

To determine eligibility and register for the lawsuit, visit the AFFF lawsuit online registration page.

Using high-quality filtration systems, such as reverse osmosis and activated carbon filters, can significantly reduce PFAS levels in household water supplies.

Avoiding nonstick cookware, water-resistant fabrics, and PFAS-laden food packaging can help limit exposure.

• Probiotics & Prebiotics: Supporting gut microbiota health can counteract PFAS-induced imbalances.
• Anti-Inflammatory Diets: Omega-3 fatty acids, fiber-rich foods, and polyphenols can reduce gut inflammation.

Supporting legislative efforts to regulate and phase out PFAS can help reduce long-term exposure risks.

The growing body of research linking PFAS exposure to ulcerative colitis underscores the urgent need for further investigation and regulatory action. By understanding how PFAS disrupt immune function, compromise gut integrity, and alter microbiota composition, we can take proactive steps to mitigate risks and protect vulnerable populations from the long-term consequences of these persistent chemicals.