Antibiotics are often prescribed for those who suffer from frequent bacterial infections. However, a study has found that the risk of IBD increases for the older population who were had to take multiple rounds of antibiotics. “Inflammatory bowel disease, which can easily be overlooked in this age group, should be considered, especially when there’s a history of antibiotic prescriptions,” lead author of the study said.
Those who had to frequently take antibiotics may be at greater risk of developing inflammatory bowel disease (IBD). This was found in a research that was presented at Digestive Disease Week (DDW) 2022. It also must be noted that the study has not been peer-reviewed or published just yet.
A previous research that was published in 2020 had established a link between antibiotic use and the onset of IBD in the younger generation. Another research was made and this was led by Adam Faye, MD, an assistant professor of medicine and population health at NYU Grossman School of Medicine in New York City. The team wanted to see whether the same connection was applicable for the older generation. They made use of the Danish National Prescription Register and they were able to point out the 2.3 million people aged 60 and older from 2000 to 2018 and assessed the number of antibiotics prescribed, the timing of antibiotics, and the impact of specific antibiotic classes on the chances of developing IBD in the older folks.
The study took 18 years to complete and during that time, researchers found 10,773 new cases of ulcerative colitis and 3,825 new cases of Crohn’s. They suggested that constant exposure to antibiotics increased their risk. They also said that environmental factors may play a significant role in developing inflammatory bowel disease for this group.
“When we think of IBD onset, we think of environmental factors and genetic factors as playing a role. So in essence, everything that is not genetically coded is considered an environmental risk factor or exposure [including antibiotic use],” explained Dr. Faye. “In younger patients, there seems to be a higher genetic risk and thus more of a family history of IBD. In older-onset IBD, family history of IBD is not as strong, suggesting less of a genetic risk, and that environment is playing more of a role to trigger IBD.”
Antibiotic Use Increased the Risk for IBD
The increase in the new diagnoses happened when antibiotics were prescribed one to two years before the actual diagnosis. However, it’s also good to note that a high risk remained for prescriptions in the two- to five-year time span before it happened. The link was established for all types of antibiotics. That is, except for nitrofurantoin. This is prescribed for those who suffer from urinary tract infections. Antibiotics prescribed for gastrointestinal infections were the ones most likely connected to the latest IBD diagnosis.
“Inflammatory bowel disease, which can easily be overlooked in this age group, should be considered, especially when there’s a history of antibiotic prescriptions,” Faye said. He, however, acknowledged that further research must be made to fully establish the connection.
Limitations of the Study
The authors did not collect data on the reason for antibiotic use. For instance, they did not look into if it was prescribed for enteric (intestinal) infections, explained Benjamin Cohen, MD. He is a gastroenterologist and the clinical director of IBD with the Cleveland Clinic’s Digestive Disease & Surgery Institute. He also wasn’t part of the study. However, he explained, “The findings should also alert physicians to consider IBD as a reason for new GI symptoms following multiple courses of antibiotics in previous years. This is important because physicians may be hesitant to perform invasive diagnostic procedures in older adults.”
There are several kinds of antibiotics that can have an effect on the intestinal microbiome. This applies to medicines that were utilized to treat other illnesses, explained Faye. “Thus, in cases where a mild illness is being empirically treated or is expected to self-resolve in a few days, it may be more prudent to hold off on antibiotics right away.”
As for what’s to come, Faye’s research team wants to focus their study on exploring the gut microbiome changes that come from antibiotic use. They also want to study if this does play a factor to IBD and how it comes about. They hope to find out more about the connection and supply further evidence for their findings.
“If we can determine the microbiome shifts that trigger new-onset IBD in older adults, perhaps there can be a role for probiotics or other therapies to restore the normal gut flora balance,” he said.
Faye also added, “Once inflammation is present, treatment needs to focus on controlling the inflammation, which often requires medication therapy. However, there is ongoing research on the role of diet and stress in maintaining remission.”
Recommended For You
