Combining a Western-style high-fat diet with antibiotic use significantly increases the risk of developing pre-inflammatory bowel disease (pre-IBD), according to new research.
Irritable bowel syndrome (IBS) affects approximately 11 percent of people worldwide. It is characterized by recurring episodes of abdominal pain, bloating, and changes in bowel habits. IBS patients with mucosal inflammation and changes in the gut’s microbial composition are considered pre-IBD.
The study included 43 healthy adults and 49 adult patients diagnosed with IBS. The researchers measured the fecal calprotectin, a biomarker for intestinal inflammation, of participants. Elevated levels of fecal calprotectin indicated a pre-IBD condition. The study identified 19 patients with IBS as pre-IBD.
Participants with the highest fat consumption were about 2.8 times more likely to have pre-IBD than those with the lowest fat intake. A history of recent antibiotic usage alone was associated with 3.9 times higher likelihood of having pre-IBD.
“Our study found that a history of antibiotics in individuals consuming a high-fat diet was associated with the greatest risk for pre-IBD,” said lead author Andreas Bäumler, professor of medical microbiology and immunology at the University of California–Davis. “Until now, we didn’t appreciate how different environmental risk factors can synergize to drive the disease.”
The body’s beneficial bacteria thrive in environments lacking oxygen such as the large intestine. Higher oxygen levels in the gut promote bacterial imbalances and inflammation. With the disruption in the gut environment, a vicious cycle of replacing the good bacteria with potentially harmful pro-inflammatory microbes that are more oxygen tolerant begins. This in turn leads to mucosal inflammation linked to pre-IBD conditions.
The study also identified 5-aminosalicylate (mesalazine), a drug that restarts the energy factories in the intestinal lining, as a potential treatment for pre-IBD.
The National Research Foundation of Korea, USDA/NIFA, and the Public Health Service supported the research.