Antibiotics and Crohn's Flare

[newdiagnosis]

It seems I am in the middle of a crohn's flare. I believe I started having symptoms a few weeks after using augmentin for a sinus infection. Is this just a coincidence or is that typically seen a few weeks after?

 

[kiny]

Broad spectrum antibiotics can potentially exacerbate crohn's disease. Pathogenic bacteria tend to exploit the ''post-antibiotic'' period, to colonize the intestine.

Invasive E coli especially, takes advantage. When broad spectrum antibiotics are given that are ineffective against invasive E Coli and aren't macrophage penetrating, E coli will be able to expand.

https://academic.oup.com/ibdjournal/article-abstract/25/4/711/5218864?redirectedFrom=fulltext

We also know that people who have taken antibiotics, are more likely to develop crohn's disease later on than those who have not.

If at all possible, broad spectrum antibiotics should be avoided in crohn's disease. If at all possible, antibiotics should be given intravenously to spare the intestine.

 

[newdiagnosis]

Broad spectrum antibiotics can potentially exacerbate crohn's disease. Pathogenic bacteria tend to exploit the ''post-antibiotic'' period, to colonize the intestine.

Invasive E coli especially, takes advantage. When broad spectrum antibiotics are given that are ineffective against invasive E Coli and aren't macrophage penetrating, E coli will be able to expand.

https://academic.oup.com/ibdjournal/article-abstract/25/4/711/5218864?redirectedFrom=fulltext

We also know that people who have taken antibiotics, are more likely to develop crohn's disease later on than those who have not.

If at all possible, broad spectrum antibiotics should be avoided in crohn's disease. If at all possible, antibiotics should be given intravenously to spare the intestine.

Thank you for your reply. So is this a permanent change? Does this type of flare need to be treated differently? It's hard to differentiate cause and effect. Previously when I used this antibiotic I did not experience this. Hard to completely avoid antibiotics especially given that we are immunocompromised and more susceptible to infections.

 

[kiny]

Once inflammation subsides you tend to see a restauration of the gut flora and an increase in diversity.

AIEC simply increases in numbers when it's no longer challenged by other bacteria when you take broad spectrum antibiotics, it's no longer competing with nutrients and it seems to thrive in inflammatory conditions. It lives in biofilms that are hard to break down (which is one of the reasons why most antibiotics are ineffective at killing AIEC), but it's most potent in inflammatory conditions, which allows it to outcompete other bacteria and break through mucosal barriers. Once inflammation subsides and the intestine heals, it's far less potent.

 

[newdiagnosis]

Very interesting. Are you a Crohn's researcher?. As a researcher myself I definitely sense that.

 

[newdiagnosis]

In hindsight, I wish I did Crohn's research. Seems pretty fascinating, especially having the disease.

 

[kiny]

I'm not a researcher, have crohn's myself. I did study biology but I had crohn during puberty and never finished any higher education. Any knowledge I gather comes from lots of reading in public libraries, corresponding with researchers and a helpful clinical toxicologist in the family who I can count on if I don't understand something.

It is fascinating like you said, the complexity of the immune system seems to know no limits. Crohn's is a highly complex disease, hopefully with a simple solution one day in the near future.

 

[kiny]

I hope you get better soon my friend.