Antibiotics: a risk factor for irritable bowel syndrome in a population-based cohort

Abstract

Objectives: Use of antibiotics affects the composition of the gut microbiome. The microbiome is thought to play a role in development of irritable bowel syndrome (IBS), but antibiotics as a possible risk factor for IBS has not been clarified. We aimed to explore if antibiotics is a risk factor for IBS by investigating use of antibiotics and development of IBS in a cohort from the Danish background population.

Materials and Methods: An internet-based web panel representative of the Danish background population was invited to participate in a survey regarding the epidemiology of IBS in 2010, 2011 and 2013. A questionnaire based on the Rome III criteria for IBS were answered at all three occasions. In 2013, a question regarding use of antibiotics in the past year was included.

Results: In 2013, use of antibiotics was reported by 22.4% (624/2781) of the population. A higher proportion of individuals with IBS reported use of antibiotics compared with asymptomatic controls [29.0% (155/534) vs. 17.9% (212/1,184), p < .01]. For asymptomatic respondents in 2010 and 2011 (n = 1004), the relative risk of IBS in 2013 related with use of antibiotics was 1.9 [95% confidence interval (CI): 1.1–3.1]. Adjusting for sex by logistic regression, development of IBS was predicted by use of antibiotics with an odds ratio of 1.8 (95% CI: 1.0–3.2).

Conclusions: Antibiotics is a risk factor for IBS in asymptomatic individuals. Possible mechanisms should be investigated in future studies.

Keywords:

• Anti-bacterial agents
• abdominal pain
• functional bowel disorders
• microbiome
• microbiota

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The study was funded by Region Zealand’s health sciences research foundation, the University of Copenhagen, the Aksel Meyer Nielsen and Vetsera Meyer Nielsen trust, the Medical Society of Copenhagen and the Trust of 1870.