Antibiotics May Rough up Your Gut

Crohn's disease and ulcerative colitis associated with antibiotic use

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) If you get a bacterial infection, you may need to take some heavy antibiotics. Beware, though… it is possible that those antibiotics may be a contributing factor for developing bowel disease.

People who have needed a lot of antibiotics may have a higher risk of inflammatory bowel disease (IBD) - which includes both Crohn's disease and ulcerative colitis.

"Use antibiotics only when prescribed by a physician."

Souradet Shaw, M.P.H., a research fellow at the University of Manitoba, and colleagues wanted to see if the the development of IBD (inflammation of the intestestines with no known cause) was associated with taking antibiotics 2-5 years before diagnosis.

The researchers found that 12 percent of people diagnosed with Crohn's disease or ulcerative colitis had three or more antibiotics prescriptions within two years of being diagnosed with the two diseases. In comparison, only seven percent of those without prescriptions developed a form of IBD.

People still seemed more likely to develop Crohn's disease or ulcerative colitis if they had large antibiotic prescriptions five years before diagnosis.

The researchers note that these findings do not necessarily mean that antibiotic use is directly causing IBD. However, they are consistent with previous studies showing that antibiotics are affecting bacteria in the gut.

"The treatment of [Crohn's disease and ulcerative colitis] centers around controlling the body’s attack on its own cells," explains Dr. Steven Kussin, author of "Doctor, Your Patient Will See You Now" and a former assistant professor of clinical medicine at Albert Einstein College of Medicine and Columbia Presbyterian. "But what stimulates this frontal assault on our own intestinal lining? More attention is being paid to the organisms that live in our gut. I call them ‘Our Gang’ and ninety percent of us are them."

Dr. Kussin continues, "Antimicrobials start a turf war with ‘Our Gang’. And this can be a bad thing. It turns out that just as there are four blood groups we also have three gut groups. Each of us, from infancy promotes the growth of certain bacteria that become ‘Your Gang’. It’s a population of flora that’s made to your immune system’s specifications. By taking too many antibiotics, many of them unnecessary, we can stop living in harmony with the micro faunal friends that are there to help us. When happy, they facilitate digestion, ramp up our immunity, activate enzymes that mange metabolism and prevent cancers, autoimmune disease, allergies and asthma. They defend us from external pathogens that can invade and cause disease. The members of ‘Your Gang’ are not just in you. In a real way they are part of you."

According to Shaw and colleagues, the results of this study suggest that antibiotic use may play a role setting the scene for the development of Crohn's disease and ulcerative colitis.

The study involved more than 24,000 people from the University of Manitoba Inflammatory Bowel Disease Epidemiologic Database. The researchers pulled information about patients' antibiotic use from the Manitoba Drug Program Information Network.

The full study - a nested case-control analysis - is published in The American Journal of Gastroenterology.

Reviewed by: 
Review Date: 
September 28, 2011
Last Updated:
October 5, 2011