Antibiotics increase functional abdominal symptoms


OBJECTIVE:Data suggest that subjects with irritable bowel syndrome are more likely to report a recent course of antibiotics. This study tests the hypothesis that a course of antibiotics is a risk factor for an increase in the number of functional bowel complaints over a 4-month period in a general population sample.METHODS:We initiated a prospective case-control study in three general practices in South London. Consecutive patients aged 16–49 attending their general practitioner with non-GI complaints and given a prescription for antibiotics were invited to participate. Comparison subjects who had not had antibiotics for 1 yr were identified from the practice records by age group, gender, and previous general practitioner visits. Fifty-eight antibiotic and 65 control patients agreed to participate. Questionnaires covering demographic, GI, and psychological data were sent at recruitment and at 4 months. Seventy-four percent of subjects completed the study. The number of symptoms at follow-up compared to that at recruitment.RESULTS:Twenty of 42 antibiotic subjects (48%) versus 11/49 control subjects (22%) demonstrated one or more additional functional bowel symptoms at 4 months (unadjusted odds ratio = 3.14 [1.27–7.75]) (χ2= 6.4, p = 0.01). Ten of 42 antibiotic subjects (24%) versus 3/49 control subjects (6%) demonstrated two or more additional functional bowel symptoms at 4 months (unadjusted odds ratio = 4.79 [1.22–18.80]) (χ2= 5.8, p = 0.02).CONCLUSIONS:Functional bowel symptoms come and go, but subjects who are given a course of antibiotics are more than three times as likely to report more bowel symptoms 4 months later than controls.

DOI: 10.1111/j.1572-0241.2002.05428.x
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@article{Maxwell2002AntibioticsIF, title={Antibiotics increase functional abdominal symptoms}, author={Penelope Maxwell and Elisabeth Rink and Dinesh Kumar and Michael Anthony Mendall}, journal={American Journal of Gastroenterology}, year={2002}, volume={97}, pages={104-108} }