Antibiotic Use Associated with Increased Risk of IBD

[Scipio]

New study:

https://gut.bmj.com/content/early/2023/01/03/gutjnl-2022-327845
"Conclusion Antibiotic exposure is associated with an increased risk of IBD, and was highest among individuals aged 40 years and older. This risk increased with cumulative antibiotic exposure, with antibiotics targeting gastrointestinal pathogens and within 1–2 years after antibiotic exposure."

This conclusion certainly comports with my own experience. I suffered appendicitis with ruptured appendix at age 59 and was heavily treated with antibiotics to knock down the high risk of peritonitis from the rupture. I was diagnosed with Crohn's one year later after developing severe anemia due to blood loss in the small bowel.

 

[J100]

I have suspected it myself that antibiotic use can lead to gut bacteria imbalance and can cause Crohn's disease. It kills off the good bacteria along with the bad bacteria. But my suspicion is not the same as evidence. It is a good study. If this is true then probiotic treatment to restore the gut bacteria may be an option. I suppose the question is what are the next steps after this study.

 

[J100]

Hi @Scipio hope you are doing well. Has there been a study which compares the gut microbiome of people with Crohn's vs gut microbiome of people without? Any differences between the two can give useful insights and potential new treatments.

 

[Scipio]

Hi @Scipio hope you are doing well. Has there been a study which compares the gut microbiome of people with Crohn's vs gut microbiome of people without? Any differences between the two can give useful insights and potential new treatments.

Yes, there have been lots of studies showing various degrees of derangement of the populations of gut bacteria in Crohn's patients. What is not so clear is whether this derangement is a cause or an effect of Crohn's disease. Did Crohn's arise because the patient somehow developed an over-abundance of "bad" bacteria and shortage of "good" ones? Or did the the composition of the gut bacteria get altered to appear "bad" due to all the inflammation, ulcers, and altered food absorption in the gut caused by Crohn's that was triggered by some other mechanism?

Seeking to cure Crohn's by replacing the bad bacteria with good ones is the whole idea behind the fecal transplantation that has threads devoted to it here on this site: https://crohnsforum.com/threads/fecal-transplants-a-guide.52400/

So far, the fecal transplantation approach has worked pretty well for curing C. diff infections, moderately well in managing (not curing) ulcerative colitis, and not so well at helping with Crohn's. But they are still trying.

There are lots of articles online about differences in the composition of gut bacteria Crohn's patients. Here is just one: https://www.science.org/content/article/crohns-disease-marked-dramatic-changes-gut-bacteria

 

[J100]

Thanks for your response and sending the link. I think extensive use of antibiotics is very likely the cause. In my case also, whenever I have had antibiotics in the last few years due to a throat infection, it has caused diaherria. And after taking oral probiotics, it has gotten better. Regardless of it being the cause or the effect, the reality is that gut bacteria imbalance is there in patients with Crohn's disease and potential treatment would definitely involve restoring that balance. Fecal transplant hasn't shown good results which is disappointing. I just hope that someone out there finds a way to restore it. In another thread in this forum had posted some trial in mice was done by delivering probiotics which had delivered good results. I just hope they trial it in humans soon and it works.