The Association Between Oral Antibiotic Use and Functional Gastrointestinal Disorders in the Context of the Gut Microbiome
Abstract
Functional gastrointestinal disorders (FGDs) are a group of chronic gastrointestinal conditions with defined symptoms but without clear etiological or pathophysiological characteristics. Some of the most common FGDs are irritable bowel syndrome (IBS), functional diarrhea (FD), functional constipation (FC), and dyspepsia (D). These conditions have a significant impact on productivity, quality of life, and healthcare utilization costs. The risk profile for FGDs involves many factors and the causal pathway between antibiotic use and FGDs remains unresolved; additional research into this relationship is needed to improve understanding and guide prevention efforts. A systematic review of the literature on antibiotics and FGD in the context of the gut microbiome revealed evidence that antibiotics disrupt the normal gut microbial environment at least temporarily, and that structure and composition of the gut microbial environment differs between FGD cases and healthy controls. However, the current literature does not provide strong epidemiological evidence of an association between antibiotic use and increased FGD risk. In a nested case-control study of active duty military personnel, risk of FGD was consistently elevated from oral antibiotic use. Additionally, risk of IBS was shown to increase in a dose-response relationship to number of antibiotic prescriptions. Several individual antibiotic classes were found to be associated with IBS, providing specificity to the relationship. Finally, the change in host immune response to gut microbiota was explored in relation to IBS cases and non-IBS controls following travelers diarrhea and antibiotic use exposures in a population of travelers. Specific antigen targets were significantly associated with IBS cases compared to controls and may provide important information in the development of biomarkers for IBS.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 26, 2020
- Accession Number
- AD1183034
Entities
People
- Amelia G. Johnson
Organizations
- Uniformed Services University of the Health Sciences