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Inflammatory bowel diseases (IBDs), like Crohn’s disease and ulcerative colitis, can be painful and debilitating, causing symptoms like chronic diarrhea, abdominal pain and cramping, bloody stools, weight loss and fatigue.
Unfortunately, they appear to be on the rise …
Past research has shown a connection between certain medications and an increase in IBDs in those over 60. But research recently published online in the journal Gut shows that if you’re in your 40s your risk could be just as high for developing one of these painful gut conditions…
The devil’s in the details
Antibiotic use has been tied to the development of IBDs previously. But Danish researchers wanted to find out why people are affected differently.
They decided to analyze the medical data of 6.1 million Danish citizens over a period of time from 2000 to 2018, seeking any connections between antibiotic dosing and timing, IBD development, and whether this varied by IBD and antibiotic type.
About 91 percent of the people in the study were prescribed at least one course of antibiotics during that time. Overall, the use of these drugs was associated with a higher risk of developing IBD.
Here’s how the data broke down…
- Those ages 40 to 60 saw their risk for IBDs jump to 48 percent, just barely edging past the over-60 crowd whose risk was at 47 percent.
- When breaking down the data by specific IBD, the risks were slightly higher for Crohn’s disease: 40 to 60-year-olds had a 62 percent risk while those over 60 saw a lower risk at 51 percent.
- Each subsequent course of antibiotics added a 15 percent risk increase to those aged 40 to 60 and 14 percent to those aged 60 and older.
- 40 to 60-year-olds prescribed 5 or more courses of antibiotics had a 100 percent higher risk and the risk for those over 60 was 95 percent higher.
- The highest risk for IBD appeared to occur 1 to 2 years after antibiotic exposure. Each year after that was associated with a risk reduction. For instance, 40 to 60-year-olds had a 66 percent risk of IBD 1-2 years after taking antibiotics. But that risk dropped to 21 percent 4-5 years later.
- When comparing antibiotic types, the highest risk of IBD was linked with nitroimidazoles and fluoroquinolones, two broad-spectrum antibiotic classes that are usually used to treat gut infections. Narrow-spectrum penicillins were associated with IBD to a much lesser extent.
Gut protection plus judicious antibiotic use
One possible explanation for the findings is that the microbes in the gut microbiome naturally weaken in resilience and range as we get older. Antibiotic use is likely to compound that age-related decline according to the researchers. And these shifts can become more pronounced with repeated courses of antibiotics, ultimately limiting recovery of the gut microbiome.
All of this can also add up to affect the permeability of the gut lining, a condition known as leaky gut.
The bottom line here is that you want to be very selective about when to take antibiotics. Remember, they treat bacterial infections, not viral ones. However, some doctors are still overly cautious and may prescribe them if they think there’s a risk a viral infection could lead to a bacterial one.
Of course, there are times when antibiotics are absolutely necessary to treat bacterial infections. When that happens, there are a couple of things you can do to protect your gut from the antibiotic’s effects:
- Take a probiotic, which will help replenish your gut’s “good” bacteria. Be careful not to take the probiotic too close to the time you take the antibiotic, as the medicine can kill off the microbes in the probiotic. A good rule of thumb is to take the probiotic 2 hours before or after taking your antibiotic.
- Add fermented, high-fiber and prebiotic foods to your diet. Some good fermented foods include yogurt, kefir, miso and sauerkraut, while foods high in fiber include whole grains, beans, lentils and cruciferous vegetables. Foods like garlic, onions and leeks are great prebiotics, which feed the probiotics in your gut and keep them healthy.
- Avoid alcohol, tobacco and artificial sweeteners, all of which can hurt your gut health and exacerbate the negative effects of the antibiotics.
One last word of advice: Don’t wait til you’re faced with taking antibiotics to protect your gut from their effects. Make it a regular practice and the benefits will be compounded.
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Antibiotic Use in the United States, 2022 Update: Progress and Opportunities — Centers for Disease Control and Prevention