Childhood infections and the risk of inflammatory bowel disease

Abstract

Adults with inflammatory bowel disease from North Carolina were questioned during 1986 and 1987 to assess risk due to a variety of childhood infections and treatments with antibiotics. Responses were compared with those of neighbor controls. Persons with Crohn's disease were more likely to report an increased frequency of childhood infections in general (odds ratio 4.67, 95% CI 2.65-8.23) and pharyngitis specifically (odds ratio 2.14, 95% CI 1.30-3.51). This was validated by an increased frequency of tonsillectomy (odds ratio 1.53, 95% CI 1.07-2.20). Crohn's cases were more likely to report frequent treatment with antibiotics for both otitis (odds ratio 2.07, 95% CI 1.03-4.14) and pharyngitis (odds ratio 2.14, 95% CI 1.20-3.84). Although Crohn's cases were more likely to report frequent exposure to penicillin (odds ratio 1.81, 95% CI 0.98-3.31), there did not appear to be excess risk conferred by penicillin after controlling for frequency of infections. Persons with ulcerative colitis also reported an excess of infections generally (odds ratio 2.37, 95% CI 1.19-4.71), but not an excess of specific infections or treatments with antibiotics. Persons who reported an increased frequency of infections tended to have an earlier onset of Crohn's disease (P < 0.0001) and ulcerative colitis (P = 0.04). Finally, it was noted that urban living in childhood increased the risk for Crohn's disease. We conclude that childhood infections may be a risk factor for Crohn's disease and may presage the early onset of disease.

Health inequalities in the life course perspective

“…Some viral infections including mumps, have been shown to increase the risks of insulin dependent diabetes mellitus in later life, together with a range of other autoimmune destructive processes [99]. Measles has been implicated in the aetiology of inflammatory bowel disease [100], and the experience of living as a child during poliomyelitis epidemics has been found to be associated with a later raised risk of motor neurone disease in population studies [101]. These are period effects, in that all are now greatly reduced.…”

Mycobacterium avium subsp. paratuberculosis in powdered infant milk: F57 competitive real time PCR

“…Comprehensive studies and reviews are available on the links of Crohn's disease with social and ethnic factors (Economou and Pappas, 2008;Hou et al, 2009), urban dwelling and communal water availability (Falkinham et al, 2008;Kaevska and Hruska, 2010;van Ingen et al, 2010), showers and bathrooms with hot water supplies (Gent et al, 1994;Duggan et al, 1998), the use of home refrigerators (Hugot et al, 2003) and higher hygienic standards (Guarner, 2007;Klement et al, 2008). Some important findings have been published as far back as 20 years ago (Thomson, 1993;Colombel and Gowerrousseau, 1994;Wurzelmann et al, 1994). All these hypotheses can be linked with bottle feeding and MAP or mycobacterial triggers of proinflammatory cytokine cascades.…”

“…All these hypotheses can be linked with bottle feeding and MAP or mycobacterial triggers of proinflammatory cytokine cascades. Gut mucose permeability and formation of immunity and exposure to mycobacterial triggers of inflammation in the first days or weeks after birth could have a delayed manifestation of inflammation in the target tissues many years later (Colombel and Gowerrousseau, 1994;Kawabata et al, 1994;Wurzelmann et al, 1994;Ponsonby et al, 2009).…”

Role of microecology in chronic inflammatory bowel diseases

“…Introduction of Western foods such as hot dogs, butter and margarine into the diets of Japanese populations increases IBD risk (Epidemiology Group of the Research Committee of Inflammatory Bowel Disease in Japan, 1994;Shoda et al, 1996). As shown in Table 1, frequent use of antibiotics for otitis or pharyngitis during childhood has also been identified as a risk factor for developing Crohn's disease (Wurzelmann et al, 1994).…”