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Detection bias and the association between inflammatory bowel disease and Salmonella and Campylobacter infection
  1. Mark S Riddle,
  2. Chad K Porter
  1. Department of Enteric Disease, Naval Medical Research Center, Silver Spring, Maryland, USA
  1. Correspondence to Dr Mark S Riddle, Department of Enteric Disease, Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; mark.riddle{at}

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We read with great interest the paper by Jess et al reporting an increased risk of incident inflammatory bowel disease (IBD) following Campylobacter and Salmonella infections.1 Their results were consistent with prior epidemiological studies of large electronic databases yielding data supportive of an association between the onset of IBD and antecedent acute infectious diarrhoea.2 3 However, Jess et al discounted the potential causal association between infectious gastroenteritis and IBD onset in a susceptible population and concluded that the observed association was a function of detection bias due to increased microbial surveillance among those with IBD-like symptoms. In support of their argument, similarities in temporal IBD risk patterns following Campylobacter- or Salmonella-confirmed infection and for pathogen-negative stool …

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