[HN Gopher] Childhood antibiotics as a risk factor for Crohn's d...
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Childhood antibiotics as a risk factor for Crohn's disease: Cohort
study
Author : Jimmc414
Score : 135 points
Date : 2022-07-09 17:05 UTC (5 hours ago)
(HTM) web link (www.ncbi.nlm.nih.gov)
(TXT) w3m dump (www.ncbi.nlm.nih.gov)
| sk8terboi wrote:
| w10-1 wrote:
| OMG, does anyone think that with samples size this small that
| this study means anything? The effect is barely significant, and
| the potential confounders could fill a dictionary.
|
| Crohn's et al is important, but this study adds little more than
| noise.
| popotamonga wrote:
| Happened to me. My doctor as a kid would just prescribed
| antibiotic for everything thing,no matter what. How can there be
| such bad doctors.
| swayvil wrote:
| It's screwy for sure.
|
| My doctor is obese and diabetic. Great doctor, wonderful
| person, but dang!
|
| There's a disconnect there.
| oneoff786 wrote:
| Why do you think they are a great doctor
| swayvil wrote:
| Because they are nice and cure my ills... Ok good question.
| lostlogin wrote:
| Careful with the incantations, you might be summoning the
| moderator.
| dham wrote:
| They still do. It's literally insane. Most will prescribe oral
| for everything even if it's just a cut. Not only will they give
| antibiotics they won't even tell someone to take a probiotic
| during treatment. Most doctors I've met over the years just
| phone it in and don't stay up to date on anything.
| kube-system wrote:
| It's partially doctors giving in to the demands of patients
| who want a prescription for everything. I think it's a side
| effect of our expensive healthcare system. People don't like
| paying their copay for just a band aid. Or to be told "it's a
| virus, get some sleep and drink fluids". They want to feel
| like they got something for their money.
| mirekrusin wrote:
| That's why we now have homeopathy placebos in pharmacies.
| Mildlypolite wrote:
| Two words : fecal transplant.
| sammyjoe72 wrote:
| I had chronic tonsillitis as a kid. The doctors treated it with
| antibiotics until finally after about 3 years they recommended I
| just get my tonsils out. I got diagnosed with UC about 14 years
| ago. Also have had psoriasis for years.
|
| I blame both on excessive use of antibiotics as a 5 - 8 yr old.
| saiya-jin wrote:
| Wife is a internal doctor (Switzerland's biggest hospital), and
| we were very wary about avoiding giving any kind of antibiotics
| before our kids reached age of 1. Common knowledge among peer
| doctors is that even single usage before 12 months significantly
| increases risk of diabetes later in life significantly (and god
| knows what other nasty side effects).
|
| In some cases they are miracle cure, with some nasty side
| effects. But general over-prescription even in relatively
| developed world is ridiculous.
|
| From my less developed and highly corrupt home (Slovakia/Czech
| republic), I often get news from friends who got prescribed full
| course of antibiotics on clearly viral infections. General
| doctors there are mostly on such an abysmal level that self-
| treatment is sometimes better than their clueless visits. Even
| for small kids.
|
| Another item are painkillers - I see prescriptions for literally
| anything, usually heavy doses of paracetamol or ibuprofen but
| I've seen worse for maladies which don't warrant it. I don't even
| take those in pharmacies unless I know I have acute inflammation
| to treat.
| Daniel_sk wrote:
| My wife is a GP in Slovakia and she has a device for a quick
| test (CRP) whether you have a bacterial infection in blood or
| not. So they don't prescribe antibiotics if the test is
| negative. And she doesn't recommend them if not necessary -
| unfortunately many patients demand them because that's what
| they expect to get. But she is maybe an exemption who cares a
| lot about each patient and invests into better equipment even
| though you are not really incentivized by the system to do so.
| refurb wrote:
| Well when your kid is screaming in pain from an ear infection,
| I'm not sure I'm going to decline to treat them with antibiotics
| because of some small future risk of Crohn's disease.
| nsgi wrote:
| Does the study recommend antibiotics not be used to treat ear
| infections? I would think the message is that it's even more
| important not to use antibiotics when they're not needed, not
| that they shouldn't be used at all
| ipaddr wrote:
| You are better off treating the ear pain because antibiotics
| are going to take awhile if it's not viral.
| robocat wrote:
| Do you think you should be writing medical advice?
|
| Ear infections are dangerous. My nurse friend decided she
| didn't need to go to a doctor for her ear pain (nurse knows
| best). A few days later two burst eardrums, blood running
| from ears. Fixing ear infections without losing hearing
| ability is a wonder of modern science. Good parents don't
| risk their children going deaf.
|
| The answer to bad doctors is not "don't go to the doctor".
|
| The answer is to go to a good doctor.
|
| It takes time and effort to find a good doctor. Worth the
| investment since health risks are very high expected personal
| costs. Or you are spending X% of your salary on health
| insurance, so the implication is that you should invest
| significant time and effort to get a good doctor.
|
| Same with house purchases: treat that like a fucking degree
| you must learn, otherwise you are just gambling with quality
| years of your life (the extra years you work to buy a bad
| decision, the quality of life of the years you spend living
| on a property).
|
| Either learn doctor and property knowledge (if you have the
| capacity to do so), or learn how to choose the right people
| to help you. Anything else is rolling the dice with your life
| and the lives of those you care for.
| [deleted]
| DantesKite wrote:
| One of the reasons why antibiotics are somewhat ineffective
| against ear infections is because the bacteria develop
| biofilm that makes it difficult for both the immune system
| and treatments to reach that area.
|
| Xylitol nose spray can help along with a humidifier and
| rubbing behind the ear to sort of try and disrupt the biofilm
| colonies.
|
| Anecdotally I've also had great success with a supplement
| called X-INFX (and I've tried quite a bit including various
| antibiotics to no avail).
|
| As far as preventative measures, keeping the inner ear dry
| with a quick dab of toilet paper or a little ear dryer pump
| goes a long ways.
|
| It also helps if you get an ear cleaner, just in case you
| have hardened wax. For whatever reason, an ear infection
| sometimes causes wax to build up inside (which is a like a
| sticky conveyor belt your body uses to "churn" out debris and
| pathogens).
|
| I make no judgement about whether or not to use antibiotics
| since that's not my expertise and I'm not a doctor. I'm just
| simply offering adjunct treatments that have historically
| worked for me and others.
|
| Best of luck everyone.
| weberer wrote:
| Maybe just give them topical antibiotics?
| rossdavidh wrote:
| On the one hand, it makes total sense to me that childhood
| antibiotics could mess up your digestive tract immune system. On
| the other hand:
|
| "Subgroup analysis showed that antibiotic use <18 years old was a
| risk factor for CD development in the Chinese (adjusted OR 4.80,
| 95% CI 1.62-12.24; P = 0.005) but not in Australian populations
| (OR 1.80, 95% CI 0.33-9.95; P = 0.498)."
|
| If it were a robust finding, it would not fall apart on subgroup
| analysis.
| xxpor wrote:
| Different antibiotics/doses/frequency of prescription in
| different countries? Haven't read the whole thing yet though.
| cpncrunch wrote:
| Just look at the results table. Even for china it looks like
| only certain age ranges show the effect. Most likely just
| random.
| [deleted]
| Saint_Genet wrote:
| I suspect (but have no science to back it up) that it's a risk
| factor for many things. I had ear infections more or less
| constantly in my childhood and were on antibiotics the whole time
| until they finally stooped working. The end result is that I'm
| now deaf on one ear. I get why they were prescribed, it stopped
| the acute pain but no one thought about the long term
| PaulKeeble wrote:
| Antibiotics are actually really more damaging than we realise.
| Western digestive tracts show significant differences in
| microbiome that those of people who do not use antibiotics as
| treatment and some of the lost species are really important. We
| also have no way to fix it currently, some of the species like
| Faecalibacterium Prausnitzii are critical to our bodies energy
| system but can't survive in oxygen, so we have no way to eat it
| at all, you kill it then its gone likely for good. Others like
| Limosilactobacillus reuteri stop fungus from inhabiting our small
| intestine as well as other bacteria but just 5% of us still have
| some of it as its very susceptible to antibiotics.
|
| We don't know what ideal microbiomes look like, we just know the
| bulk of people living in the western world have unhealthy ones
| that are missing key species and we have only scratched the
| surface of understanding.
| [deleted]
| bobbylarrybobby wrote:
| How are bacteria that can't be eaten first acquired by infants?
| PaulKeeble wrote:
| Passed to them from their mother while in the womb. Seems to
| be transferred at birth but there is some evidence it happens
| earlier too.
| refurb wrote:
| Source?
|
| Amniotic fluid and blood is sterile.
|
| Newborns acquire their biome once born by ingesting various
| food and contact from family members.
| jamal-kumar wrote:
| I had really bad IBS from consuming water on a tropical island in
| Panama one time and suffered for a few years with even my doctor
| friend telling me "Damn that sucks, not much you can do except
| manage". Pretty horrible symptoms until I discovered L. Reuteri.
| [1] I read that it's been a bacteria that was more commonly found
| in samples until around the 1950s when people started consuming
| more garbage processed food and was sold. Simply stated, it
| changed my life. It emits a substance called Reuterin which
| inhibits the growth of other more harmful bacterial species. [2]
| I can't speak personally for suffering on the level of Crohn's
| disease, but there's positive research out there regarding it.
| [3] [4]
|
| [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5917019/
|
| [2] https://en.wikipedia.org/wiki/Reuterin
|
| [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270012/
|
| [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468961/
| AdmiralAsshat wrote:
| Fellow IBS-sufferer here. Runs in my family.
|
| So doing a search for "Reuteri" on Amazon, I immediately see
| several pages worth of supplements, with such helpful reviews
| as "HELPS DIGESTION. ENLARGES TESTICLES."[0]
|
| How do you separate the trustworthy supplements from the snake
| oil?
|
| [0] https://a.co/d/4Qa1iy1
| vimy wrote:
| If reddit anecdotes are to be believed the enlarged testicles
| are true.
|
| https://www.reddit.com/r/Supplements/comments/9pdrg1/my_expe.
| ..
|
| https://www.reddit.com/r/Supplements/comments/m3ywju/questio.
| ..
|
| There are more but just linking these two.
| bbarnett wrote:
| In places like this on reddit, so many posts are just
| influencer accounts.
|
| You'd probably be better off reading such reddit forums,
| and presuming the exact opposite happens.
|
| This is another area to clean up, in the digital age.
| heavyset_go wrote:
| Just echoing this. I've worked with marketing agencies
| who use Reddit to post things like this for their
| clients.
|
| Both of those posts have the OP linking to specific
| products, with one of the OPs blatantly posting a
| referral link to a specific product.
|
| Even without the links or mentioning specific products or
| brands, marketers will post things like this to build up
| markets, audiences and anticipation for new products, in
| this case it is a specific species and variant of
| bacteria.
| jamal-kumar wrote:
| There's one supplier I trust out of Sweden called Biogaia.
| [1] Look for the keith haring lookalike box art. I don't buy
| anything off of that website but it's something you can get a
| couple of weeks supply of from the pharmacy for under 100$.
|
| Amazon is so full of scams, Jeff Bezos really needs to be
| held to account for that.
|
| [1] https://www.biogaia.com/
| unicornporn wrote:
| > There's one supplier I trust out of Sweden called Biogaia
|
| Which supplement from them are you referring to?
| lstamour wrote:
| Probably https://www.biogaia.com/product/biogaia-gastrus/
| ?
| oneoff786 wrote:
| Having any sort of active microbiome is probably a good idea
| and an intended aspect of the human digestive system. I don't
| know that this one specifically is better or worse but I
| would probably consider probiotics a decent idea to try.
|
| The testes thing is... I guess vaguely plausible. I'm bemused
| everyone in the reviews seems to be confident that this is
| desirable. It seems like desperate people are just flocking
| to some study on rats.
| AdmiralAsshat wrote:
| Sure, but the parent comment was suggesting a specific
| bacterium, so I would want to make sure whatever probiotics
| I'm buying contain it. And normally I would probably just
| rely on getting them through a trusted vendor (e.g. my
| neighborhood grocer/pharamcy/health food store), but if I'm
| forced to shop online to make sure it has this specific
| thing in it...I want something I can check to vouch for its
| quality, yeah?
|
| For example, pretty much every bottle of probiotics you buy
| will claim it contains "Over XX billion CFUs (colony-
| forming units?) in every pill!" But, are more better? Are
| they the right kind? Will I get 60 billion CFUs in a pill
| if I just dehydrate some pond water?
| markdown wrote:
| > And normally I would probably just rely on getting them
| through a trusted vendor (e.g. my neighborhood
| grocer/pharamcy/health food store), but if I'm forced to
| shop online to make sure it has this specific thing in
| it...I want something I can check to vouch for its
| quality, yeah?
|
| Oddly enough, with the food/supplement I'm most familiar
| with, kava, the worst quality you can find is in brick
| and mortar establishments. The trusted vendors are all
| online-only and dedicated entirely to the one product
| instead of just trying to stock their shelves with every
| supplement on the planet.
| AdmiralAsshat wrote:
| Well I guess my thought process (however incorrect it
| might be) is that from a _food safety_ perspective--not
| necessarily a supplement efficacy perspective--there 's a
| greater bar to pass for the FDA to allow something to sit
| on the shelf at CVS than to get it from some random
| vendor on Amazon that might not even reside in the US.
| emmelaich wrote:
| https://iherb.com/search?kw=Reuterin
| ARandomerDude wrote:
| > Fellow IBS-sufferer here. Runs in my family.
|
| I see what you did there.
| collegeburner wrote:
| Interestingly, may not be all wrong:
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3879365/
|
| Yes its shitty chumbucket type marketing but there's still
| some potential.
| folli wrote:
| Reuterin which is a broad spectrum antibiotic... Ironic.
| webstrand wrote:
| How did it change your life? Did you take a supplement
| containing it, or was it some experimental treatment?
| jamal-kumar wrote:
| I don't have the shits every day anymore. Got it at a
| pharmacy.
| DantesKite wrote:
| Along those same lines, Visbiome and homemade kefir (the kind
| at the store isn't technically kefir) helped me out immensely.
| ThrowawayTestr wrote:
| Where do you get it?
| jamal-kumar wrote:
| Pharmacy
| rhexs wrote:
| Go to any health food store and they'll have a refrigerated
| section of all the placebo bacteria supplements you could
| ever want.
| jamal-kumar wrote:
| You speak from a position of disparagement but I'm living
| proof -\\_(tsu)_/-
| danielheath wrote:
| The world has no shortage of "I don't understand this so
| it couldn't be important" in daily life, let alone
| online.
| oneoff786 wrote:
| You can test if a probiotic is actually alive. They may not
| provide the effect you want but they're probably not
| placebos. The good ones at least.
| anonporridge wrote:
| Test I found if anyone else is wondering.
|
| https://drformulas.com/blogs/news/probiotic-milk-test-
| how-do...
| yumraj wrote:
| Since it's a Lactobacillus, I wonder if you can take the
| supplements and introduce it in home made yogurt?
|
| Then just consume the yogurt regularly.
|
| Not sure if anyone has ever tried anything like that..
| bsilvereagle wrote:
| It looks like this strain will indeed culture a yogurt -
| https://www.luvele.com/blogs/recipe-blog/how-to-make-l-
| reute...
| yumraj wrote:
| This is seriously awesome. We make yogurt at home anyway,
| so it is very easy to introduce this.
|
| I'm assuming we can just add this to our culture and not
| make yogurt using just this, but I guess that will require
| some experimentation.
| bluechair wrote:
| Yes you can make yogurt out of it. Technically speaking,
| lactobacillus refers to the fact that this bacterium produces
| lactic acid not that it consumes lactose.
|
| It's easy to confuse.
|
| I just finished making 2 liters of yogurt with this bacterium
| this morning.
| yumraj wrote:
| Is your yogurt culture just this bacteria or did you start
| with regular yogurt culture and added this?
| metadat wrote:
| Which tropical island, specifically?
|
| It sounds horrible, I'm sorry that happened to you.
| ng12 wrote:
| > Damn that sucks, not much you can do except manage
|
| This has been my entire experience with gastroenterology as a
| field. Once they rule out cancer there's really not much they
| can do for you. Meanwhile, I'm waiting for the revolution in
| our understanding of the microbiome.
| Mildlypolite wrote:
| My advice is to go to microbiome experts like Dr Borody, he
| has a lot more tools to help like fecal transplants and
| antibiotica for Crohn (long story, look at his videos).
| Borody is the one who invented the triple antibiotics therapy
| for the helicobacter pylori.
| wincy wrote:
| I've been throwing up for a year straight. Recently it has
| gotten worse. The only thing that seems to help is weight
| loss. I just feel like there's shit in the back of my throat
| multiple times a day (which I mean, there is) but the only
| way to clear it to my body's satisfaction is throwing up.
| Gastroenterologist took a look and said everything looked
| fine. Thanks, doc, very helpful.
| kevinmchugh wrote:
| I couldn't swallow pills before, my gastroenterologist
| performed surgery which corrected that. She also proscribed
| pills which address my GERD
| ng12 wrote:
| That's fair. Guess I'm mostly talking about the other end
| of the system :)
| Aaargh20318 wrote:
| Do you need to keep taking this or is it enough to take it a
| while and repopulate your guts ?
|
| How long until you saw results ?
| jamal-kumar wrote:
| I took a couple of 40$ boxes of it for a few weeks and ever
| since, I've had no problems. Pretty great!
|
| I buy a box every now and then since then just to keep it up.
| It's like the most expensive probiotic on the shelf, but it
| works.
|
| Oh yeah, and I also stopped consuming crap that goes in the
| fridge or freezer ready to eat a long long time ago. I think
| that might have something to do with it. They found that
| there's certain harmful bacterial species which proliferate
| in such environments [1]
|
| [1] https://ask.usda.gov/s/article/Can-bacteria-grow-in-the-
| refr...
| sprokolopolis wrote:
| Also, people who are eating too many pre-
| made/processed/frozen foods might not be eating enough
| fresh, organic fruits and vegetables, which are a great
| source of helpful bacteria and the prebiotic fibers that
| keep them alive.
| sgammon wrote:
| this is fascinating, thank you for sharing
| codeTired wrote:
| The healthcare needs to be completely overhauled. So many doctors
| are completely ignorant of risks of antibiotics and other meds.
|
| There was a study that found 7% of doctors reported adverse
| reactions. Some were scared, some didn't know how, some didn't
| have time. Some doctors made no reports in nearly lifetime of
| practice.
|
| When I was 16-22 I had multiple 6+ months courses of doxycycline
| for acne. I have seen multiple dermatologist who said nothing can
| be done about my cystic acne. At some point I was tired of doxy
| making me feel awful so I researched different skin types and
| skin care routines. As long as I use a mild soap twice a day, use
| a moisturizer and don't touch my skin I get 0 cystic acne but it
| took weeks to see the results. No doctor ever told me about
| different types of skin and I was young and dumb. My parents
| didn't know any better. And internet wasn't as popular back then.
|
| Then, I got an adverse reaction to cipro. And 40+ doctors ignored
| it. Told me it's all in my head. Told me to seek help for my
| mental health and depression. Later FDA added warning about
| permanent nerve damage. I still have to send studies to doctors
| because they try to tell me I'm wrong, after I had every test
| under the sun to rule out other causes.
|
| I help admin flouroquinolone toxicity group and every day we get
| individuals who were given these last resort meds for suspected
| infection. It is border line medical malpractice. However, I have
| seen that it is impossible to find a lawyer to take the case and
| find a physician willing to testify.
|
| There needs to be a better system for tracking allergic reactions
| and trends. For example, cipro might show no reaction up to 6
| months. Then, you snap your Achilles. The doctor won't tell you
| it was cipro unless you tell him. It's fucked and extremely
| underreported.
| bejelentkezni wrote:
| >So many doctors are completely ignorant of risks of
| antibiotics and other meds.
|
| Not ignorant, complicit.
| ReptileMan wrote:
| >The healthcare needs to be completely overhauled. So many
| doctors are completely ignorant of risks of antibiotics and
| other meds.
|
| Doctors are well aware by my talks with them. There is
| unfortunately a large subset of the population that unless
| prescribed antibiotics feel that they have not been taken care
| by the doctor. So there is quite a demand.
| ipaddr wrote:
| Are there any techniques for recovery you discovered?
| Madmallard wrote:
| If you were damaged enough for long term side-effects it is
| likely to an extent an irreversible process, as it trends to
| be for many diseases.
|
| That's not to say you can't have some recovery and adapt,
| just that what you were before is never coming back.
|
| I developed diastolic dysfunction and severe sensitivities
| and food intolerances after Cipro and other antibiotics in
| 2014. The only way there could be a persistent diastolic
| dysfunction is if there has been permanent damage to the
| cells of the heart.
|
| If he has input as to things which helped him I'd love to
| see, but as far as I understand, if the mechanism is indeed
| mtdna depletion and mutagenesis from excessive ROS then I
| don't really see how you actually cure that.
| swayvil wrote:
| The problem is how knowledge in managed in our society.
|
| A central authority administering truth to the greater unwashed
| mass is the popular method.
|
| And it seems to be built into us, to get our truth that way.
| Truth is what the authority tells us. Contriving truth yourself
| is generally considered a perversion.
|
| So there's that inertia, keeping the knowledge management
| system stuck this way.
|
| Maybe high-quality society-wide pervasive knowledge is
| impossible.
| victorclf wrote:
| I research every prescribed treatment side effects after
| levofloxacin gave me bilateral achilles tendinitis. In my
| experience, potential side effects and complications from
| treatments are never discussed with patients.
|
| I also had the displeasure of suffering from the mental side
| effects of the antiallergic montelukast, which again were not
| even mentioned by the doctor despite the serious FDA warning.
| tcbawo wrote:
| Doctors in the USA have no feedback mechanisms to know whether
| treatments work or not. They're probably falling back to
| hunches in marginal cases. Also, if you are discussing
| treatment options with parents or patients, advising against
| antibiotics is a losing battle: the parent/patient gets angry
| whether you are right or wrong. The question of whether
| antibiotics would be helpful or ineffective means there is
| asymmetric risk. Even long term risks are unknown on an
| individual case by case basis.
| codeTired wrote:
| There is definitely a mix of issues. Some patients expect
| antibiotics because they paid for the visit.
|
| However, every physician should be able to present patient
| with different options and risks. It simply is not happening.
| Some antibiotics carry smaller risks than flouroquinolones as
| this drug belongs to topoisomare II inhibitors along with
| chemo drugs. Some reactions we are seeing are much like
| damage from chemo. However, the action of damage is still
| very poorly understood. There is some research on
| mitochondrial dna damage and adducts.
|
| There recently has been talk if flouroquinolone antibiotics
| could be a potential cancer treatment even.
|
| If I knew I would never touch this antibiotic unless on my
| death bed.
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