New Delhi: Frequent use of antibiotics can add to the risk of developing inflammatory bowel disease (IBD) among those above 40 years of age, suggests a new study published in the journal ‘Gut’. IBD, which includes Crohn’s disease and ulcerative colitis, is a group of disorders that cause chronic pain and swelling in the intestines.
According to the study, which involved analysing the medical data of over six million Danish citizens, aged 10 years and above, 36,017 new cases of ulcerative colitis and 16,881 new cases of Crohn’s disease were diagnosed in the country between 2000 and 2018. Compared with no antibiotic use, the study says use of these drugs was associated with a higher risk of developing IBD.
“Overall, compared with no antibiotic use, use of these drugs was associated with a higher risk of developing IBD, regardless of age. But older age was associated with the highest risk,” researchers found. The risk seemed to be cumulative, with each subsequent course adding an additional 11%, 15%, and 14% heightened risk, across the age bands. The highest risk of all was observed among those prescribed five or more courses of antibiotics; 69% heightened risk for 10-40 year olds; a doubling in risk for 40-60 year olds; and a 95% heightened risk for the over 60s, the study said.
As to the antibiotic type, the highest risk of IBD was associated with broad spectrum antibiotics such as the nitroimidazoles and fluoroquinolones that are usually used to treat gut infections, it adds.
Some plausible biological explanations for the findings include the natural diminution of both the resilience and range of microbes in the gut microbiome associated with ageing, which antibiotic use is likely to compound. “Furthermore, with repeated courses of antibiotics, these shifts can become more pronounced, ultimately limiting recovery of the intestinal microbiota,” the researchers have pointed out. Limiting prescriptions for antibiotics may not only help to curb antibiotic resistance but may also help lower the risk of IBD, they advise.
Dr Randhir Sud, chairman of the Medanta Institute of Digestive and Hepatobiliary Sciences, said the results of the study, though important, should be taken with an pinch of salt. “In India, overuse of antibiotics is very common. If that was the sole cause or risk factor for IBD, we would have a deluge of such cases. I feel there must be another compounding factor behind the development of IBD,” Dr Sud said. He, however, stressed on the need to regulate the use of antibiotics.
“90% of people suffering from diarrhoea do not require antibiotics. Maintaining hydration is enough. Diarrhoea is a self-limiting disease. Similarly, most fever and chest infections are often caused by viral infections and popping broad spectrum antibiotics are of no use in such cases,” he said.