Acid Suppression Drugs and Antibiotics Given to Infants Strongly Associated with Celiac Disease

Summary: Celiac.com 11/07/2022 - A team of researchers recently set out to investigate why certain at-risk individuals develop celiac disease. They especially wanted to look at the risk levels early on that might influence levels of celiac disease later on in childhood. The research team included Michael Boechler MD; Apryl Susi MS; Elizabeth Hisle-Gorman MSW PhD; Philip L. Rogers; and Cade M. Nylund MD. They are variously affiliated with the Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD, and the Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD. For their retrospective cohort study, the team used the Military Healthcare System (MHS) database, the team found children born between October 1, 2001- September 30, 2013. The team examined the connections between patients who received either proton pump inhibitors (PPI), histamine-2 receptor antagonist (H2RA), or antibiotic prescriptions in the first six months of life, and who also had a celiac disease diagnosis in early childhood. They then searched outpatient prescription records for antibiotic, PPI, and H2RA prescriptions in the first 6 months of life. They used ICD-9 codes to identify children who made outpatient visits for celiac disease, and Cox proportional hazards regression to calculate the hazard ratio (HR) for the development of celiac disease based on medication exposure. Nearly one-million children met inclusion criteria, from which the researchers uncovered just over 1,700 cases of celiac disease. Average follow-up time for patients in this group was about 4.5 years. The data show that PPI’s, H2RA’s, and antibiotics were all associated with an increased hazard of celiac disease. Children who receive antibiotics, PPI’s and H2RA’s in the first 6 months of life face an increased risk for developing celiac disease. The data reinforce the notion that controllable factors, such as the use of drugs to treat conditions in infancy, could help to lower the childhood risk of celiac disease for many people worldwide. Read more in The Journal of Pediatrics