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Published on: August 7, 2017
Association between early childhood otitis media and pediatric inflammatory bowel disease: an exploratory
Souradet Y Shaw1, James F Blanchard, Charles N Bernstein
1Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Winnipeg, Manitoba, Canada.
Insights
Early childhood otitis media (middle ear infection) is linked to a higher risk of developing pediatric inflammatory bowel disease (IBD). This association suggests otitis media may indicate increased antibiotic exposure, a potential factor in IBD development.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Infectious Disease
Background:
- Pediatric inflammatory bowel disease (IBD) encompasses Crohn's disease and ulcerative colitis, with complex etiologies.
- Otitis media (middle ear infection) is common in early childhood and often treated with antibiotics.
Purpose of the Study:
- To investigate the association between early childhood otitis media diagnosis and the subsequent development of pediatric inflammatory bowel disease (IBD).
Main Methods:
- A nested case-control study utilized a population-based IBD database in Manitoba, Canada.
- 294 children with IBD were matched with 2377 controls, analyzing physician claims for otitis media diagnoses before IBD onset.
- Multivariate conditional logistic regression adjusted for physician visits to assess the association.
Main Results:
- By age 5, 89% of IBD cases had an otitis media diagnosis versus 82% of controls.
- Children with an otitis media diagnosis by age 5 were 2.8 times more likely to develop IBD (95% CI, 1.5-5.2; P=.001).
- The association was significant for both Crohn's disease and ulcerative colitis.
Conclusions:
- Early childhood otitis media is significantly associated with an increased likelihood of pediatric IBD diagnosis.
- Otitis media may serve as a proxy for increased antibiotic use, a potential contributing factor to IBD.
- Further research is warranted to explore the link between early infections, antibiotic exposure, and IBD pathogenesis.
Objective:
To determine whether a diagnosis of otitis media in the first 5 years of childhood is associated with the development of pediatric inflammatory bowel disease (IBD).
Study Design:
This was a nested case-control analysis of a population-based IBD database in Manitoba, Canada. A total of 294 children with IBD diagnosed between 1989 and 2008 were matched to 2377 controls, based on age, sex, and geographic region. The diagnosis of ottis media was based on physician claims. IBD status was determined based on a validated administrative database definition. Multivariate conditional logistic regression models were used to model the association between otitis media and IBD, adjusted for annual physician visits.
Results:
Approximately 5% of the IBD cases and 12% of the controls did not have an otitis media diagnosis before that IBD case date. By age 5 years, 89% of the IBD cases had at least one diagnosis of otitis media, compared with 82% of the controls. In multivariate analyses, compared with cases and controls without an otitis media diagnosis, individuals with an otitis media diagnosis by age 5 years were 2.8-fold more likely to be an IBD case (95% CI, 1.5-5.2; P = .001). This association was detected in stratified models examining Crohn's disease and ulcerative colitis separately.
Conclusion:
Compared with controls, subjects diagnosed with IBD were more likely to have had at least one early childhood episode of otitis media before their diagnosis. We suspect that otitis media serves as a proxy measure of antibiotic use.
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