INFECTIOUS GASTROENTERITIS IN RELAPSES OF INFLAMMATORY DISEASE - THERAPEUTIC IMPLICATIONS

The incidence and clinical importance of infectious gastroenteritis wa s studied in 67 consecutive relapses of inflammatory bowel disease (IB D). A stool culture. was done in every case before starting treatment. Stool culture was positive in 6 relapses (8.9%): Four were exacerbati ons of ulcerative colitis and two of Crohn's disease (8.8% in ulcerati ve colitis vs 9% in Crohn's disease; NS). The microorganisms isolated were Campylobacter yeyunii in three cases, Salmonella enteritidis in t wo and Staphylococcus aureus in one case. There were not clinical diff erences between patients with positive and negative stool culture. Tre ated with antibiotics, stool cultures became negative in all of them b ut only in three the disease was controlled. The other three had to be treated with corticosteroids to achieve remission. We conclude that s tool culture should be practised in all relapses of IBD and in case of positivity, antibiotic therapy should be started. With this approach the use of corticosteroids can be avoided in some patients.