Gut 60:i-ii doi:10.1136/gut.2011.238311
  • Digest


  1. Alexander Gerbes, Editor and Deputy Editors

Enteric infections and risk of IBD

Enteric infections with Salmonella and Campylobacter have been suggested to play an aetiological role in IBD. However, the risk of detection bias in relation to this observation has not been studied. In this issue of Gut, Jess et al attempt to answer this important question. They followed the entire Danish population during the period from 1 January 1992 to 31 December 2008 with notice of dates for occurrence of first infection with Salmonella or Campylobacter, first negative stool test or a diagnosis of IBD, and until occurrence of the outcome of interest, emigration, death or the end of the study (31 December 2008). The study covered >94 million person-years of observation and revealed that the risk of both CD and UC is markedly increased not only following an enteric infection with Salmonella or Campylobacter but even more so, following a negative stool test. The findings strongly suggest that the risk previously ascribed to acute bacterial gastroenteritis reflects detection bias related to increase stool testing rather than causality. See page 318.

Incidence rate ratios (IRRs) with 95% CIs for Crohn's disease as a function of time since the first positive stool test for Salmonella or Campylobacter or the first negative stool test relative to the background population, Denmark, 1992–2008.

Lactulose hydrogen breath test measures oro-caecal transit, not SIBO

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