In a study from NYU Grossman School of Medicine and elsewhere, scientists found frequent use of antibiotics may heighten the risk of inflammatory bowel disease—Crohn’s disease and ulcerative colitis—among adults over 40,
They found the risk seems to be cumulative and greatest 1-2 years after use and for those antibiotics targeting gut infections.
Mounting evidence suggests that environmental factors are likely implicated in the development of inflammatory bowel disease (IBD).
One factor linked to IBD risk in young people is the use of antibiotics, but it’s not clear if this association might also apply in older people.
In the study, the team drew on national medical data from 2000 to 2018 for Danish citizens aged 10 and upwards who hadn’t been diagnosed with IBD.
They specifically wanted to know if the timing and dose of antibiotics might be important for the development of IBD and whether this varied by IBD and antibiotic type.
The team used data from more than 6.1 million people who were included in the study, just over half of whom were female.
In total, 5.5 million (91%) had been prescribed at least one course of antibiotics between 2000 and 2018. During this period, some 36,017 new cases of ulcerative colitis and 16,881 new cases of Crohn’s disease were diagnosed.
The team found overall, compared with no antibiotic use, use of these drugs was associated with a higher risk of developing IBD, regardless of age. But older age was linked to the highest risk.
Those aged 10-40 were 28% more likely to be diagnosed with IBD; 40-60 year-olds were 48% more likely to receive this diagnosis, while those over 60 were 47% more likely to do so.
The risks were slightly higher for Crohn’s disease than they were for ulcerative colitis: 40% among 10-40 year-olds; 62% among 40-60 year-olds; and 51% among those over 60s.
The risk seemed to be cumulative, with each subsequent course adding an additional 11%, 15%, and 14% heightened risk, according to the age band.
The team found timing also seemed to be influential, with the highest risk for IBD occurring 1-2 years after antibiotic exposure, with each subsequent year thereafter associated with a lowering in risk.
As to antibiotic type, the highest risk of IBD was associated with nitroimidazoles and fluoroquinolones, which are usually used to treat gut infections.
These are known as broad-spectrum antibiotics because they indiscriminately target all microbes, not just those that cause disease.
Nitrofurantoin was the only antibiotic type not linked to IBD risk at any age.
Narrow spectrum penicillins were also associated with IBD, although to a much lesser extent.
The team says this adds weight to the notion that changes in the gut microbiome may have a key role and that many antibiotics have the potential to alter the composition of microbes in the gut.
If you care about inflammation, please read studies about Vitamin D deficiency linked to chronic inflammation, and eating six prunes per day to prevent inflammation.
The study was conducted by Adam Faye et al and published in the journal Gut.
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