No Causal Link Found Between Celiac Disease and Antibiotic Exposure

FRIDAY, May 1, 2026 (HealthDay News) -- Individuals with celiac disease (CD) are more often exposed to antibiotics before their diagnosis, but data suggest heightened surveillance rather than causality may contribute to the observed patterns, according to a study published online April 27 in Clinical Gastroenterology and Hepatology.Maria Ulnes, M.D., from Sahlgrenska Academy at the University of Gothenburg in Sweden, and colleagues examined prior antibiotic use in individuals with biopsy-verified CD versus their matched general population comparators and siblings in a nationwide study (2007 to 2023). Antibiotic use was assessed up until one year before diagnosis/matching in 27,789 individuals with biopsy-verified CD, 133,451 comparators, and 33,112 siblings. Secondary analyses included 225,548 individuals with histologically normal mucosa and 1,089,796 matched comparators.The researchers found that earlier antibiotic exposure was more common in patients with CD than comparators (69 versus 63 percent; adjusted odds ratio, 1.24). When analyses were restricted to antibiotics at least five years before CD diagnosis, the adjusted odds ratio was 1.15. There was an increase seen in the association with the number of dispensations (adjusted odds ratios, 1.21 and 1.35 for one to two and for at least three, respectively, versus none). In sibling comparisons, the association between CD and prior antibiotics persisted (any use: adjusted odds ratio, 1.29). Among individuals with normal mucosa, an even stronger association was seen (adjusted odds ratio, 1.50); the risk was particularly high in those with at least three earlier dispensations (adjusted odds ratio, 1.80)."It's easy to think that celiac disease is a result of antibiotic exposure," Ulnes said in a statement. "However, the connections are much more complex. It's possible that factors such as susceptibility to infection and dietary habits contribute to the development of celiac disease, possibly through an impact on the gut microbiota. In this case, adequate use of antibiotics does not appear to pose a risk in itself."One author disclosed ties to the pharmaceutical industry.Abstract/Full Text (subscription or payment may be required)

No Causal Link Found Between Celiac Disease and Antibiotic Exposure

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