Extensive use of antibiotics is associated with the development of colitis and Crohn’s disease

Extensive use of antibiotics is associated with the development of colitis and Crohn's disease

A new study finds that the more antibiotics older adults take, the higher their risk of developing inflammatory bowel disease (IBD).

The findings could help explain some of the increase in Crohn’s disease and ulcerative colitis (common types of inflammatory bowel disease) among older adults, according to the study authors.

“In older adults, we think that environmental factors are more important than genes,” lead researcher Dr. Adam Fay said. He is an assistant professor of medicine and population health at New York University’s Grossman School of Medicine in New York City.

“When you look at younger patients with new diagnoses of Crohn’s disease and ulcerative colitis, there is generally a strong family history. But that’s not the case in older people, so something in the environment is causing that,” Fay said. Press release from the upcoming Gastroenterology Week meeting.

For the study, Fay and colleagues analyzed the prescription records of 2.3 million adults aged 60 and over in Denmark newly diagnosed with IBD from 2000 to 2018.

Researchers found a link between any antibiotic use and higher rates of IBD, and the risk rose significantly with each course of antibiotics.

Compared with those who had not used antibiotics in the past five years, one course of antibiotics was associated with a 27% increased risk of IBD, two courses with a 55% higher risk and three courses with a 67% higher risk. Four cycles were linked with a 96% higher risk, and five or more cycles with a 236% higher risk, the researchers reported.

The study found that those who had taken antibiotics within the past year or two had the highest rates of new IBD diagnoses, but the risk remained high for those who had taken the medication in the previous two to five years.

An increased risk of inflammatory bowel disease has been found for all types of antibiotics except for nitrofurantoin, which is commonly prescribed for urinary tract infections. Antibiotics commonly prescribed for gastrointestinal infections were the most likely to be associated with a new diagnosis of IBD.

Fay said the findings show that clinicians should consider IBD when seeing older adults with new GI symptoms, especially if they have a history of antibiotic use.

The study also highlights the need for careful use of antibiotics to prevent IBD and antibiotic resistance.

“Antibiotic supervision is important, but avoiding antibiotics at all costs is not the right solution either,” Fay said. “If you’re not sure what you’re dealing with, I’d be careful. If patients come in with obvious infections, and need antibiotics, they shouldn’t be withheld by these findings.”

The study results are due to be presented Sunday, May 22nd at the Digestive Disease Week meeting in San Diego. Results presented at medical meetings should be considered preliminary until they are published in a peer-reviewed medical journal.

Are you overdoing on antibiotics?

more information:
There’s more about inflammatory bowel disease at the Crohn’s & Colitis Foundation of America.

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