A Swedish team of scientists led by Dr. Karl Mårild, recently reported a link between taking antibiotics and the development of celiac disease Celiac disease is an autoimmune reaction to gluten proteins contained in wheat, rye and barley. The disease process causes inflammation and villus atrophy (which means the little hair-like projections in the small intestine that allow us to absorb nutrients become flattened and loose function). People who express the certain proteins (HLA-DQ2 or –DQ8) on the surface of their white blood cells are genetically predisposed to the disease. The condition affects approximately one percent of the population and is linked to numerous other autoimmune diseases, neurological disorders, cancers, anemia, osteoporosis, itchy dermatitis, digestive damage and digestive malabsorption. In my book, Fast Tract Digestion IBS, I talk about the connection between celiac disease, IBS and SIBO. People with celiac disease more often diagnosed with IBS[ii] or SIBO.[iii],[iv] The question is why? What do these conditions have in common that could explain this connection? In each case, the small intestine becomes inflamed, the absorptive surface of the small intestine is damaged and foods, especially carbohydrates, are poorly digested leading to bacterial overgrowth. Like celiac disease, antibiotics can also increase the risk developing IBS. What happens to the digestive tract and gut microbiome when people take antibiotics certainly deserves much more attention. Antibiotics dramatically change the gut microbiome by killing off many healthy bacteria. This puts people at increased risk for C diff infection, SIBO and IBS. Leaning more about the role of antibiotics in changing the gut microbiome may lead to a better overall understanding of the cause of celiac disease, SIBO and IBS leading to better treatments. We know that gluten-free diets don’t correct the problem in approximately one third of cealics. Are there other aspects of this condition that we need to understand to help these individuals? I wouldn’t be surprised if fermentable carbs such as resistant starch, fiber, fructose and other sugars – not limited in gluten free diets – are part of the answer. But avoiding antibiotics when they are not absolutely needed should be standard practice to maintain our diverse gut microbiome providing more protection against celiac, IBS and other SIBO-related conditions. [i] Mårild K, Ye W, Lebwohl B, Green PH, Blaser MJ, Card T, Ludvigsson JF. Antibiotic exposure and the development of coeliac disease: a nationwide case-control study. BMC Gastroenterol. 2013 Jul 8;13:109. [ii] Nelsen DA Jr. Gluten-sensitive enteropathy (celiac disease): more common than you think. Am Fam Physician. 2002 Dec 15;66(12):2259-66. [iii] Tursi A, Brandimarte G, Giorgetti G. High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal. Am J Gastroenterol. 2003 Apr;98(4):839-43. [iv] Rubio-Tapia A, Barton SH, Rosenblatt JE, Murray JA. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol. 2009 Feb;43(2):157-61.
Antibiotics Linked to Celiac Disease
[i]. Note: You can download the entire article free.
About the Author: Norm Robillard
Norm Robillard received his Ph.D. in microbiology from the University of Massachusetts, Amherst studying Bacillus anthracis and other Bacillus species. His post-doctoral training at Tufts University focused on antibiotic resistance and gene transfer between the gut microbes Bacteroides fragilis and E. coli.
During his career in pharma / biotech, Dr. Robillard studied the genetics of antibiotic resistance, septic shock, viral illnesses and antimicrobial and antibody-based therapies prior to founding the Digestive Health Institute. Dr. Robillard is the creator of the Fast Tract Diet, author of the Fast Tract Digestion book series and publisher of the Fast Tract Diet mobile app. He was the first to propose excess intestinal fermentation as the underlying cause of acid reflux and explained the connection between intragastric pressure from gas-producing bacteria in our intestines, nutritional malabsorption and the symptoms of acid reflux. His latest book series, Fast Tract Digestion provides a safe and effective dietary tool and behavioral strategy as an alternative to proton pump inhibitors (PPIs), H2 blockers, IBS drugs or antibiotics for heartburn, acid reflux, GERD, laryngopharyngeal reflux disease (LPR), IBS and other SIBO related conditions.
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Thank you for interesting article Dr. Robillard!
“We know that gluten-free diets don’t correct the problem in approximately one third of cealics. Are there other aspects of this condition that we need to understand to help these individuals?”
I am reading a book “The Paleo Approach: Reverse Autoimmune Disease, Heal Your Body” by Sarah Ballantyne now. And the author supposes that there are antinutrients in all grains, legumes and nightshade vegetables which act very similar to gluten. They all promote “leaky gut” and destroy our health. So gluten diet just doesn;t excludes all that is needed to exclude actually.
PS I am still shocked with all this information about “healthy” whole grains and etc.. :)
I know this is an old article, but I wanted to add to it. In 2007 into 2008, I was put on antibiotics multiple times. Let’s say I was given my first dosage in Jan. By September I was still taking them. I suffered from quite a few infections that year. The treatments were not working. When they finally successed, I still had to be pre-medicated prior to dental work. This dental work happened between March and September of 2008.
By the middle of September, I got really sick. I didn’t know what was going on. I spent the next three years, unable to pass a regualar BM (once a month if I was lucky), throwing up everyday, etc. I thought I had stomach cancer. By 2011, I realized “fiber” made me sick. Within a week, I learned about gluten. It was not the fiber from cereal or other foods/meds, it was the gluten. I developed Celiac Diease in 2008. In 2014, I still can not eat gluten (or have any medication – a dentist almost killed me because I’ve now developed interolances to almost anything synthenic and he failed to believe me about having a reactions to the local anesthesia. Yes people can be allergic to the local anesthesia! Too many young dentists think differently.) Even if a small crumb, I’m in the bathroom for about 8 hours (straight) with cramps worse than childbirth, horrid diarreah, rash itching, dizziness and non stop vomiting. It takes MONTHS to recover, and I become cognitively impaired, suffer from hair loss and a few other things. I want to add that I suffered from other autoimmune disorders like hyperthryodism/hypothyrodism and symptoms of Lupus. Since stopping with gluten I have not had any problems with my TSH levels at all. I no longer get “lupus-like” flare ups. I get “glutened” all of the above comes back.
I did not have Celiac’s or IBS before being left with an undiagnosed parasite and 7 rounds of antibiotics. Is there a cure for this situation which is making my life EXTREMELY challenged. Travel is affected severely as are family dinners, holiday celebrations etc.
I believe my possible celiac diagnosis was due to using probiotics but am told that cannot be the case. I truly believe I changed my gut or a and not for the better! Is this even possible?