Childhood infections and the risk of inflammatory bowel disease
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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.
Key wordsCrohn's disease epidemiology inflammatory bowel disease ulcerative colitis antibiotics penicillin
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- 1.Mendeloff AI, Calkins BM: The epidemiology of idiopathic inflammatory bowel disease.In JB Kirsner, RG Shorter (eds). Inflammatory Bowel Disease. Philadelphia, Lea and Feibiger, 1988, pp 3–34Google Scholar
- 10.Acheson ED, Truelove SC: Early weaning in the aetiology of ulcerative colitis. Br Med J 2:929–933, 1961Google Scholar
- 12.Koletzko S, Sherman P, Corey M, Griffiths A, Smith C: Role of infant feeding practices in the development of Crohn's disease. Br Med J 298:1617–1618, 1989Google Scholar
- 14.Breslow NE, Day NE: Statistical Methods in Cancer Research. Vol 1. The Analysis of Case-Control studies. Lyon, International Agency for Research on Cancer, 1980Google Scholar
- 16.Mantel N: Chi-square test with one degree of freedom: Extensions of the Mantel-Haenszel procedure. J Am Stat Assoc 58:690–700, 1963Google Scholar
- 19.Koletzko S, Griffiths, Corey M, Smith C, Sherman P: Infant feeding practices and ulcerative colitis in childhood. Br Med J 302:1580–1581, 1991Google Scholar
- 22.Kirschner BS, Newcomb SA: Increased prevalence of rheumatic fever in the relatives of pediatric patients with chronic inflammatory bowel disease. Gastroenterology 86:1135, 1984Google Scholar