
Antibiotics nearly double risk of developing IBD, doctors warn - rajnathani
https://www.studyfinds.org/antibiotics-double-ibd-risk/
======
azinman2
Makes a lot of sense. We know so little about the trillions of bacteria inside
of us, and taking a nuke to them all is going to have consequences. There are
probiotics tuned for IBD on the market, and one can only imagine the
complexities of the ecological dynamics.

I personally believe that in 100 years there will be a real bacterial
awakening in science understanding how much our microbiome affects so much
about our health and happiness, and will look at antibiotics as a Neanderthal-
like in their oversimplification.

~~~
autisticcurio
Many antibiotics dont actually kill gram negative/positive bacteria, they
merely prevent them from reproducing. Now if you want to kill bacteria, look
to Russian phages, or swallow some sea water where a 1ml sample will contain
billions of phages but its pot luck if any of them are right one's you need
for your bacterial infection. One other little know fact about antibiotics, is
the penicillin based one's get metabolised in the liver into penicillamine
which is used to reduce copper levels in the body and ironically copper also
helps to kill bacteria.
[https://www.nature.com/articles/151107a0](https://www.nature.com/articles/151107a0)
Considering what Penicillamine does to the body and how it affects Vit B6, you
can see why you get pain in different parts of the body when you take too much
Vit B6, however its also a good way to find out where bacterial levels are
high in the body, dental fillings can be a common area. Creatine gets broken
down into creatinine and happens to be one of the few things that can kill
both gram negative and gram positive bacteria, of course you need to consume a
lot of it though, but havent worked out why we get told to not consume
creatine for more than a few weeks though. Anyone know?

~~~
pazimzadeh
One downside to phages is that they replicate. Once you stop taking
antibiotics, there is no risk that the treatment will replicate and
potentially mutate inside of you. Otherwise, I agree.

With regards to creatinine, I'm sure you'd want to generally suppress your
bacterial load if you don't have symptoms or an active infection. That could
leave the door open for a worst bacteria or fungus to come along and fill the
niche.

~~~
autisticcurio
My understanding based on an expert here in the UK is that Phages only
replicate as long as there is the bacteria around that they were bred to
infect and replicate in. As soon as the bacteria levels drop, phages die as
there is essentially no food for them to consume. Considering the timescales
to develop phages for a strain of bacteria (2 weeks), the ideal treatment is
antibiotics, then phages to complete the job, because even Flemming stated
when he discovered Penicillin, you need to keep taking these antibiotics until
the infection is gone, but today many doctors just prescribe a course for
7-14days, and then you have to go back to get another course if they will
prescribe another course, at least on the NHS its like that, and thats when
you can get an appointment in my experience. Also bacteria can go into
dormancy developing biofilms in different parts of the body and creatinine
wont work then. As the immune system attacks the food we eat bar some
exceptions like starch as the only sugar not attacked, when we do a water only
fast the number of immune cells drop as the numbers are not needed to attack
the food. So the lower number of immune cells concentrate on attacking
pathogens and faulty cells. Considering Lent used to be 40days of water only
fasting, and there was no modern medicine back then, it seems observation and
trial and error over thousands of years highlighted a suitable way to keep
religious followers healthy, a necessary requirement for religions back then.
Today science can explain why water only fasting works for so many illnesses.
It seems Herbet Shelton was good at observing considering what we know about
Vit D
[https://web.archive.org/web/20110222200902/http://www.soilan...](https://web.archive.org/web/20110222200902/http://www.soilandhealth.org/02/0201hyglibcat/020127shelton.III/020127.toc.htm)

However, one of the reasons why his Hygienist methods ie water only fasting
were not popular is because some undiagnosed health conditions caused sudden
deaths when on a water only fast, so this is why water only fasting is not
popular in the medical industry, but Socrates called water only fasting the
physician from within, so even the ancient Greeks had made their own
observations of what worked way back then with their limited toolset.

------
rfreytag
Read _Never Home Alone_, ch 10 "Look What the Cat Dragged in
([https://magazine.scienceconnected.org/2020/05/book-review-
ne...](https://magazine.scienceconnected.org/2020/05/book-review-never-home-
alone/)) to learn about Toxoplasmosis gondii to blow your mind.

The whole book is excellent and there is supporting evidence therein about our
personal biota impacting our health, especially around allergies.

------
sparkie
Purely an anecdote: I wrote in a related thread about 5 years ago how I had an
allergic reaction and my guts became a mess after taking antibiotics for the
first time in my life (around age 23)
[[https://news.ycombinator.com/item?id=10555891](https://news.ycombinator.com/item?id=10555891)].
I managed to get better by changing my diet. In 2017 I had another course of
antibiotics, got very ill again and was hospitalized, diagnosed with IBD (UC),
and spent nearly 13 weeks in hospital. Only thing that keeps me in remission
now is Azathioprine. Had to cut back on the fibre too, now my diet is mainly
meat. I also became lactose intolerant, where I'd been drinking milk all my
life up to 2017 (age 30).

~~~
PaulBGD_
This is a shot in the dark, but I had taken antibiotics to treat an infection
twice last fall, then suddenly this summer have been having unexplainable (so
far) stomach issues. Given the somewhat longer period after taking the
antibiotics, is the length of time somewhat similar to yours?

~~~
sparkie
Yeah, it could be similar. (Can't remember clearly first time as it was 10
years ago now).

Second time my stomach complaint got really bad, my doc assumed it was
gastroenteritis and prescribed me more antibiotics. They were useless, and he
figured it might be IBD a few weeks later and prescribed me some steroids
(Prednisolone). The dose of steroids prescribed was useless as I already had
severe symptoms by then, so I ended up hospitalized and pumped with a high
dose of Hydrocortisone. If it were a few days later I probably would've been
dead.

For a few months before my guts were bad, I was having pains in my chest
(around the bottom of the ribcage). The doctor thought it was gallstones, but
a UV scan came back negative. The pains in the lower part of the colon came
afterwards, along with the diarrhoea.

------
ng12
I cannot wait until we discover a basic understand of the human microbiome. As
a practice, gastroenterology is very good at diagnosing and dealing with
cancer and very bad at dealing with anything else. IBS/IBD is basically a
blanket diagnosis handed out when your doctor has no idea what's wrong with
you.

~~~
joshgel
IBD is very different from IBS. IBD is an autoimmune disease with a pathologic
diagnosis (ie requires a biopsy and microscopic evaluation for diagnosis).
It’s treated as almost autoimmune diseases are.

IBS is a syndrome (the S in the name) which usually implies a constellation of
findings, but not a specific disease process. From the name you can know that
the disease process hasn’t been clearly elucidated.

~~~
blix
IBD is a catch-all for several different diseases, which are all poorly
understood. There is still a debate over whether or not their cause is
physical or psychological. There's a big gap between observing inflammation or
related markers and actually understanding the disease. Even within the same
subdiagnosis, people respond vastly differently to treatments, which more or
less can all be described as intentionally crippling the immune system to stop
inflammation. It's not uncommon for people with IBD to have tried a roulette
of medications with questionable efficacy and dangerous side effects. If you
talk to three different doctors you will get three different treatments and/or
lifestyle change recommendations. I know several people who have quit all
medications after this experience and turned to and alternative/holistic
approach.

IBD shares this lack of understanding and heavy handed approach with many
other autoimmune diseases. Being in this category is not a good thing. It's
not unfair to lump IBD/IBS together; people who have these conditions share a
lot of the same issues and struggles.

~~~
deorder
3 years ago I got diagnosed with IBS after I landed in the hospital with a
stabbing pain just right next to my belly button (sometimes I still feel it
lightly) what they first thought was caused by kidney stones. Nothing turned
up on the xrays or echoes. Since then things have only gotten worse as if it
has spread upwards first causing constipation, then silent reflux (causing a
constant burning sensation in my throat, mouth and nose), pain in my neck,
foggy brain (which started recently) and so on. The GP, which in my country
decides if I have to be forwarded to a specialist to relieve the medical
system, keeps attributing everything to my IBS. Once I got the diagnosis IBS
it is as if they stopped taking me seriously and act as if I am just being a
hypochondriac so I decided to just let it be.

~~~
trhway
[IANAD] what you describe might as well be SIBO (as far as i understand in my
limited non-professional understanding the bacterial overgrowth can cause the
IBS symptoms too though fortunately i was spared that). It took some years in
my case to stumble upon definitive test - the lactose based breath test - with
all these years doctors dismissing it as "just take the antacid" (which is
actually no-no for SIBO), and even with the definitive diagnosis confirmed by
the test it is still a struggle to get a right doctor to correctly treat it.

~~~
deorder
Yes, they gave me different antacids and so far nothing has helped. I wish it
was just like a regular acid reflux, but best way to describe it is as if
there is a cloud of aerosolized acid being released from my esophagus 24/7
that is spreading and causing an non-stop burning sensation everywhere it gets
inside my throat, mouth, nose, eyes and I think it is damaging my larynx. None
of the usual advice seems to help. Days that I am feeling better I can eat an
entire chocolatebar, mint tea, lay / sleep flat, everything I should not do
and it does not get worse. Something I noticed though is that it disappears
everytime I go on vacation and actually eat worse than usual (McDonald's etc.)

Never had any test done for SIBO I think. They did a stool test, sigmoidoscopy
and found nothing. That is how I ended up being diagnosed with IBS.

------
steve_adams_86
I once had to take antibiotics like crazy for a long time because I had some
pain in the ass strep that wouldn’t go away. It was quite the experience.

Afterwards, my breath was bizarre smelling, I had these horrible sulphuric
burps for months, and I couldn’t digest ANYTHING properly. It was misery. I
had such painful gas from indigestion so frequently that eating totally lost
its appeal.

This stacks up right in my experience. I stay far from antibiotics as a rule,
but if you need them, you need them. I hope I never need them again.

~~~
maybookers
Sounds familiar to me. Had two big antibiotic treatments after dental
surgeries last year. This did not feel right. How did you get rid of the
problems? Change in diet?

~~~
steve_adams_86
This is insanely anecdotal and doesn't hold any scientific integrity, but:

I ate a lot of raw, sometimes fermented, vegetables and fruit. Generally high
in fibre. I avoided foods I'd need to wash much because I was trying to fill
my system with a diversity of bacteria. A bit of dirt was part of the goal. I
ate stuff out of my garden, from a little local organic farm, foraged foods
like berries and mushrooms, etc.

No idea if that's what helped, but I'm totally fine now. Whatever I did before
wasn't working, or wasn't working quickly. Once I went to my mostly plant-
based "dirty" diet, so to speak, the improvement was rapid. But it didn't
happen in isolation, either. I also reduced my intake of animal proteins
mostly, which would probably be a significant factor in digestion. Eggs would
reduce the presence of sulphuric gases especially.

I'm not a believer in pro-biotics (they don't seem to support diversity, which
seems essential), but I believe people should eat a lot of diverse bacteria in
their foods. Things like wild mushrooms, plants grown in your yard that aren't
extensively washed and peeled. Don't cook everything to death. Let some little
critters into your system and let them do their thing. Assuming you don't get
the particularly bad ones (usually easy to avoid if you know how the food is
grown), I can't think of easier ways to introduce the diversity required to
properly populate your GI tract.

Again though, I have no idea what I'm talking about. I'm just some guy who
eats dirty carrots in his yard.

------
refurb
Some observations:

\- I'm surprised they could find controls who had never received antibiotics.
I assume this over some time period and not lifetime

\- For each exposure to antibiotics, there was a stepwise increase in risk
from 1.11 to 1.38 to 1.55

\- When they matched them to siblings, the risk went down (1.35 versus 1.88)
suggesting a genetic component to the overall risk

~~~
vharuck
My guess is the control group wasn't made of people with no history of
antibiotics. They just used the model to predict the risk difference between
zero and one time of taking antibiotics. The control was people from the
general population, and the "test" was people who had already developed IBD.

Though there are people, like me, who are allergic to many common antibiotics.
Between some bad reactions in childhood and an emergency three years ago (over
two decades), I never had antibiotics.

~~~
refurb
Taking another look, I think they are measuring antibiotic dispensations
_within the time period_. Which makes a ton more sense because I'm imaging the
number of people who have never been exposed to an antibiotic over their
entire lifetime is pretty small.

------
55555
How solid is the evidence that accutane causes IBD? Because most people who
took accutane would have first taken antibiotics, which is a more common
treatment for acne.

It's strange that these two drugs, with two different mechanisms of action,
would both increase risk of IBD.

I took both and I have IBD. Stay away from this stuff unless you really need
it.

~~~
cellularmitosis
I can raise your anecdata to two: I took lots of antibiotics as a kid for ear
infections, then lots more as a prelude to acutane, and 15 years later I have
proctitis.

------
topspin
Antibiotics cured my IBD. Had problems for years. A brief course of
amoxicillin and some other, now forgotten, antibiotic (taken for unrelated
reasons,) ended it almost immediately. It was amazing.

What wasn't so good was catching C. diff. soon after, almost certainly because
of the aforementioned antibiotics.

Another treatment of yet another antibiotic dealt with that.

Net result; no IBD.

~~~
miek
Related: Antibiotics cured, for about a year, my severe gluten and corn
intolerance. Then the gluten intolerance ame back. Ive gone through a few
rounds of eliminating the gluten issues in this fashion, but the symptoms
always return 10-16 months later.

~~~
CallMeJim
You may have small intestinal bacterial overgrowth [1].

If you can't digest certain types of food, the bacteria which feed on this
food grow out of proportion to their place in the microbiome. You'd often
notice symptoms an hour or more after eating the food in question, which would
give time for the food to hit the small intestine almost entirely undigested.

Taking antibiotics would kill off the overgrowth, but it would grow back over
time unless you cut out the food or took supplementary digestive enzymes along
with the food.

[1]:
[https://en.m.wikipedia.org/wiki/Small_intestinal_bacterial_o...](https://en.m.wikipedia.org/wiki/Small_intestinal_bacterial_overgrowth)

------
ineedasername
Honestly I thought that was pretty well known already. I knew a girl in
college about 20 years ago who had been on massive amounts of anti-biotics,
and it ruined her stomach & digestive system in some way. At the time she was
having to slowly build up "good" bacterial through some type of specialty
yogurts (might just have been probiotics, which were not as prevalent then).
It was a multi-year process though, and she couldn't eat a lot of types of
food in the meantime.

~~~
mleonhard
Why didn't she just get a fecal transplant?

~~~
Madmallard
Because you can't. They're reserved for c-diff infections and there isn't much
risk data on use cases outside of that such that regular providers won't give
it the OK.

------
jasimmohdk
Let me explain my case here. 2 months back I was having stomach pain around
the abdomen, it comes and goes, especially its a bit high after taking food.
Consulted doctor, and he gave medicines assuming its gastritis, without
antibiotics. Lipid profile was normal, SGPT was a bit higher (55 U/L)A Urea
Breath test showed that I am positive for H-Pylori.

A USG abdomen showed a gaseous proximal colon along with mild wall thickening
of sigmoid and adjacent descending segment around left lilac fossa
(Radiologist assumed either spastic colon/ sequela of colitis). The Doc
started treatment with antibiotics Amoxidin(Amoxicillin) +
Flagyl(Metronidazole) for 14 days along with Gordex and Gaviscon for
gastritis. After 14 days, the pain has drastically reduced, but I started
having constipation, minor fissure. Consulted doc again, and he gave
Flagyl(Metronidazole) for 7 days along with lactulose. Stomach pain actually
went away when I started taking lactulose also H-Pylori was not detected on
the next test(using H-Pylori antigen stool test).

When I stopped the medicines again, the constipation and occasional stomach
pain came back. I started taking lactulose 2 times a day after the 14 + 7 days
antibiotic course, everything was smooth, but when I stopped lactulose,
stomach pain came back. I have then started reading about the symptoms and
somewhere I read about gut flora and how antibiotics damages gut flora, on
reading much I started asking my doc about probiotics.

He recommended a probiotic which said Colon support containing 20 billion CFU.
The mix of probiotics was Bifidobacteria blend(18 billion CFU) (Bifidobacteria
lactis, Bifidobacteria infantis, Bifidobacteria longum, Bifidobacteria breve,
Bifidobacteria bifidum)) along with Lactobacillus Blend(1.5 Billion CFU)
(Lactobacillus rhamnosus, Lactobacillus plantarum, Lactobacillus casei,
Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus
helverticus) and Stephalococus Thermophilus (500 million CFU). Taking a
probiotic capsule for 6 days has improved a lot, and I have a smooth stomach
motion, and doesn't have the stomach pain or constipation anymore.

What I knew from Doc is, if we eat prebiotic (Food with good fiber), it is
decomposed by good bacteria and they reproduce good. On the other hand, if you
take high sugar, it usually helps the bad bacteria growth like H-Pylori or E
Coli. I was taking this advice and taking a lot of salads in these days.

------
amriksohata
Ayurvedic practitioners always said stay away from western medicine, chemicals
the rip out your gut and change your doshas.

Back in the day these good bacteria were found in milk, but now its
homogenised and pastuerised they are killed off. THe reason we need to
pastuerise the milk is to kill TB, but TB became more prominent after the
industrial revolution.

Our demand for industralisation has created the mess we are in now.

------
nix23
To help make a "Map" of our gut bacteria, think about "benchmarking" your new
Ryzen System with that ;)

[https://www.worldcommunitygrid.org/research/mip1/overview.do](https://www.worldcommunitygrid.org/research/mip1/overview.do)

------
theonemind
I got lactose intolerant for a few months after some antibotics. It went away
again after a while.

------
corty
Wouldn't the application method be a large influence here as well? I imagine
that adverse effects from oral application should be more pronounced in the
stomach and bowels than with IV use.

------
mleonhard
The next thing to test: Does a fecal transplant after taking antibiotics
eliminate the increased risk of developing IBD?

------
sjg007
I believe it

