Crohn's disease in childhood tied to antibiotic use
5 November 2010
More evidence has emerged linking Crohn's disease in children to changes in bacteria and other organisms in the bowel – and it could be a consequence of antibiotic use, according to research published in the journal Gut (online, 2010 Oct 21).
Crohn's disease is a type of inflammatory bowel disease (IBD) - a chronic (long-term) condition in which the wall of the bowel becomes inflamed.
A large Danish prospective study is the first to show a strong association between taking antibiotics and the development of IBD, specifically Crohn's, in childhood, its authors say.
The study followed up more than half a million children born in the 8-year period 1995 to 2003. It found that children who had taken antibiotics had almost twice the risk of developing IBD as non-users of antibiotics. Those who had 7 or more courses of antibiotics had a 7 times greater risk of developing IBD than non-users.
The researchers found children had a 12% increase in IBD risk for each course of antibiotics, and the risk was greatest in the first 3 months after a course.
However, it could not be concluded that the antibiotics caused Crohn's disease from an observational study like this, the authors warned. (An observational study compares people who have the disease with those who do not and looks for other differences between them.) Further research was needed to investigate both antibiotic use and the specific reasons for their use, they wrote.
"In particular, prescribing of antibiotics to children with intestinal symptoms of as yet undiagnosed Crohn's disease should also be considered as a possible explanation", they said.
Crohn's expert Dr Carl Kirkwood (PhD) of the Murdoch Childrens Research Institute, Melbourne, said the findings supported one of the major areas of Crohn's research – the search for microbial triggers.
"My take on it is that antibiotics may alter the gut, which then predisposes different triggers … for the cascade of events which lead to Crohn's", he said.
In all likelihood it was not simply antibiotics altering the bowel that caused Crohn’s directly, but that alterations allowed bacteria and other organisms to multiply that might trigger Crohn’s in people who are genetically susceptible, he said.
Last Reviewed: 05 November 2010
- Hviid A, Svanström H, Frisch M. Antibiotic use and inflammatory bowel diseases in childhood. Gut 2010 Oct 21. [Epub ahead of print]. doi:10.1136/gut.2010.219683. http://gut.bmj.com/content/early/2010/10/21/gut.2010.219683.abstract (accessed 5 Nov 2010).
