Acute gastroenteritis is followed by an increased risk of inflammatory bowel disease

Gastroenterology. 2006 May;130(6):1588-94. doi: 10.1053/j.gastro.2006.02.004.


Background & aims: Bacterial intestinal infections have been implicated as a possible cause of exacerbation of inflammatory bowel disease (IBD). We explored the relationship between infectious gastroenteritis and the occurrence of IBD using data from the General Practice Research Database.

Methods: A cohort of patients aged 20-74 years with an episode of acute infectious gastroenteritis (n = 43,013) was identified. From the same source population, an age-, sex-, and calendar time-matched control group free of gastroenteritis was sampled (n = 50,000). Both cohorts were followed up for a mean duration of 3.5 years.

Results: The estimated incidence rate of IBD was 68.4 per 100,000 person-years after an episode of gastroenteritis and 29.7 per 100,000 person-years in the control cohort. The hazard ratio of IBD was 2.4 (95% confidence interval [CI], 1.7-3.3) in the gastroenteritis cohort compared with the control cohort, and the excess risk was greater during the first year after the infective episode (hazard ratio, 4.1; 95% CI, 2.2-7.4). The relative risk of developing Crohn's disease in the gastroenteritis cohort was greater than that of ulcerative colitis, especially during the first year after the infective episode (hazard ratio, 6.6; 95% CI, 1.9-22.4).

Conclusions: Our results are compatible with the hypothesis that infectious agents causing an episode of infectious gastroenteritis could play a role in the initiation and/or exacerbation of IBD.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Age Distribution
  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Comorbidity
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Gastroenteritis / diagnosis*
  • Gastroenteritis / epidemiology*
  • Gastroenteritis / therapy
  • Humans
  • Incidence
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / epidemiology*
  • Inflammatory Bowel Diseases / therapy
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Spain / epidemiology