Gary is right about
being too quick. Correlation is not causation, and there are very good ideas about
antibiotics and toxins out there. But nutrition is likely in the mix too. When you leap from "shows an association" to "suspected culprit" you begin to introduce logical flaws. The suspicion is only a hypothesis to be tested, and any emerging understanding has to fit with other things that are also known.
Easy to say, but hard to grasp fully. IBD is understood to be a complex mix of genetic susceptibility (which varies in degree and kind) and environmental triggers. Further it is generally mediated by changes in the gut microbiome, but some changes also appear to be consequential to IBD. Back to complex.
Nothing says there can't be a single or predominant trigger in some cases (for some genotype), and that it is a combination of nutrition and antibiotics (and/or other toxins) in other cases.
I think we need to avoid either/or thinking. Some nutrition changes may present no threat unless accompanied by concurrent effect of antibiotics on the gut microbes, and vice versa.
Some infectious agents may initiate gut microbe changes, and some my exploit gut microbe changes, and in some cases none of this unfolds unless the mucosa leaks - meaning some triggers may have to occur in a certain order in the pathogenesis of some types of IBD.
I also disagree with statements like "if diet is the cause then diet will be the solution" or even "if ___ is the cause then ___ will be the solution. If sugar destroys a car engine, will removing sugar or applying protein fix the engine?
Instead of tearing down any bit of evidence that seem to point in a direction we don't like, we should be thinking more about
how to integrate various bits of knowledge into a more complex framework. BECAUSE IBD IS COMPLEX. If it wasn't all the clever researchers would have made more progress much sooner.
Post Edited (DBwithUC) : 1/25/2014 11:13:32 AM (GMT-7)