Antibiotic use, childhood affluence and irritable bowel syndrome (IBS)

Background Antibiotics cause well defined short-lived disturbances in bowel habit. There is evidence to suggest that antibiotics may play a role in the pathogenesis of IBS. Atopy has been associated with small household size in childhood and could also play a role in IBS. We conducted a survey examining the relation of drug use and other epidemiological correlates of IBS. Setting General practice health screening clinic. Subjects and methods 421 subjects (46% male, mean age 47 years (range 18-80 years) attending a general practice health screening clinic were interviewed by a research nurse and completed a previously validated questionnaire. Symptoms of IBS were said to be present if abdominal pain with 2 or more Manning criteria symptoms occurred more than once per month over the previous 6 months. Results 48 subjects had symptoms of IBS. The following were strongly related to its presence: antibiotic use [adjusted OR 3.70 (1.80-7.60)], female sex and childhood living density <1 person per room [OR 3.47 (1.57-7.64)], manual father's occupation [OR 0.35 (0.16-0.76)]. The use of NSAIDS, H2 antagonists or other types of medication was not greater in this group. Conclusion Antibiotic use is associated with IBS. The association with antibiotic use requires testing in prospective studies. Privileged childhood living conditions were also an important risk factor which is consistent with an allergic aetiology for IBS.