Antibiotic use for GI infection ups risk of developing IBS

Treatment with antibiotics appears to increase the risk of irritable bowel syndrome (IBS) development, particularly following a gastrointestinal (GI) infection, suggests a study.

A group of investigators searched Medline, Embase, and Scopus, along with relevant conference abstracts and citation tracking, up to 15 June 2025. Studies reporting new IBS diagnoses in patients with documented antibiotic exposure vs controls without exposure were included.

Two reviewers independently extracted data and performed quality assessment. The investigators then obtained the pooled incidence rates per 1,000 person-years, along with incidence rate ratios (IRRs) with 95 percent confidence intervals (CIs). They also conducted metaregression analysis to examine the impact of confounding covariates.

Thirty-one studies, consisting of 422,350 participants (244,632 antibiotic users), met the eligibility criteria. Overall, the pooled IBS incidence was 26 percent among antibiotic users compared with 20 percent among nonusers (IRR, 1.3, 95 percent CI, 1.07‒1.58; p=0.008).

Sensitivity analyses on studies in which antibiotics were used for GI infections revealed a higher risk of developing IBS for antibiotic users (IRR, 1.71, 95 percent CI, 1.16‒2.51; p=0.007), with high heterogeneity (I², >90 percent) among studies.

“Geographical area, criteria for IBS diagnosis, and study quality were associated with estimated effects, explaining the observed heterogeneity,” the investigators said.

“[T]he significant study heterogeneity reduces the power of our results, suggesting that further high-quality research is needed to clarify this relationship,” they added.

IBS, a disorder of gut-brain interaction, impairs patients’ quality of life, according to the investigators.