CHILDHOOD INFECTIONS AND THE RISK OF INFLAMMATORY BOWEL-DISEASE

Adults with inflammatory bowel disease from North Carolina were questi oned during 1986 and 1987 to assess risk due to a variety of childhood infections and treatments with antibiotics. Responses were compared w ith those of neighbor controls. Persons with Crohn's disease were more likely to report an increased frequency of childhood infections in ge neral (odds ratio 4.67, 95% CI 2.65-8.23) and pharyngitis specifically (odds ratio 2.14, 95% CI 1.30-3.51). This was validated by an increas ed frequency of tonsillectomy (odds ratio 1.53, 95% CI 1.07-2.20). Cro hn's cases were more likely to report frequent treatment with antibiot ics for both otitis (odds ratio 2.07, 95% CI 1.03-4.14) and pharyngiti s (odds ratio 2.14, 95% CI 1. 20-3.84). Although Crohn's cases were mo re likely to report frequent exposure to penicillin (odds ratio 1.81, 95% CI 0.98-3.31), there did not appear to be excess risk conferred by penicillin after controlling for frequency of infections. Persons wit h ulcerative colitis also reported an excess of infections generally ( odds ratio 2.37, 95% CI 1.19-4.71), but not an excess of specific infe ctions or treatments with antibiotics. Persons who reported an increas ed frequency of infections tended to have an earlier onset of Crohn's disease (P < 0.0001) and ulcerative colitis (P = 0.04). Finally, it wa s noted that urban living in childhood increased the risk for Crohn's disease. We conclude that childhood infections may be a risk factor fo r Crohn's disease and may presage the early onset of disease.