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Background: The multi-drug resistance 1 (MDR1) gene is reported to correlate with the function and the expression of P-glycoprotein (P-gp), and the carriers of MDR1 C3435T polymorphism are speculated to have an increased susceptibility to ulcerative colitis (UC) in western countries. The aim of this study is to investigate whether MDR1 C3435T polymorphism is a susceptible marker for the onset of UC in Japanese patients.