Clinical ventilatory dysfunction in CIDP is usually not an indicator of poor prognosis, and many patients recover without significant permanent disability. The mortality rate is similar to intubated patients with GBS. Patients with cardiopulmonary comorbidities and acute GBS-like onset of CIDP may be at higher risk of ventilatory failure which typically responds to 'standard' treatments of CIDP. Larger prospective studies are needed to define the prevalence, clinical spectrum and significance of ventilatory involvement in CIDP and to establish guidelines for evaluation and treatment.
There are scarce data on risk factors for post-infectious irritable bowel syndrome (PI-IBS). The objective of this study was to determine the risk factors of developing PI-IBS following an acute infectious gastroenteritis (AGE) episode in which, by laboratory tests, the etiological agent was isolated. The study was conducted on patients admitted to a tertiary center of infectious diseases during three consecutive years. The patients were divided into two groups: a group consisting of patients admitted with AGE (with an isolated etiological agent) and a control group consisting of patients admitted for an acute upper respiratory tract infection (URTI). The subjects were recalled in our center 6 months after the admission and were evaluated with Rome III IBS diagnostic questionnaire and Bristol Stool Form Scale. The questionnaires were paper printed and directly filled in by the subjects. The response rate in the case group was 5% and in the control group 100%. The prevalence of PI-IBS was higher in patients with AGE, presenting a relative risk (RR) of 4.16 [95% confidence interval (CI), 1.89-9.17], statistically significant (P<0.001) vs. URTI. From 28 female patients, 22 patients (79%) developed PI-IBS and from 17 male patients, 3 patients (18%) had developed PI-IBS with a risk of 4.4 (95% CI, 1.56-12.65), P<0.001. Regarding the infectious etiology of the AGE, Campylobacter jejuni had the highest risk of developing PI-IBS, RR=1.2 (95% CI, 0.13-3.11), P=0.04 compared with the other agents with a lower risk. The risk to develop PI-IBS after AGE infection is 4.16 higher than after URTI. Female sex is a risk factor for PI-IBS, 79% of the female patients developed PI-IBS after AGE. The incidence of PI-IBS is highest in patients with Campylobacter jejuni AGE compared with the other agents.
After acute infectious gastroenteritis, up to thirty percent of patients present prolonged gastrointestinal symptoms and a part of those affected patients can have the diagnostic criteria for postinfectious irritable bowel syndrome.Treatment is symptom directed rather than curative and includes agents prescribed for the treatment of irritable bowel syndrome in general. Prophylaxis or early treatment of acute bacterial diarrhea may reduce the risk of postinfectious irritable bowel syndrome development by reducing the occurrence, duration, and severity of the chronic inflammation and mucosal alterations (all these believed to play an important role in disease persistence). Probiotic treatment is effective in restoring the intestinal microbiota in patients with irritable bowel syndrome and in animal models there are improvements of postinfectious irritable bowel syndrome. Fecal microbiota transplantation seems to be one of the most effective methods of treating the postinfectious irritable bowel syndrome (with recurrent episodes) caused by Clostridium difficile.
Background Post-Infectious Irritable Bowel Syndrome (PI-IBS) is a common complication of Clostridioides difficile infection (CDI). The objectives of this study were to asses the risk of PI-IBS following a CDI. We also evaluated if there is a correlation between the onset of PI-IBS and the severity of CDI.Methods The study group consisted of 69 patients consecutively admitted in a tertiary center with an acute gastroenteritis episode, suspected of having a Clostridioides difficile infection. PCR for CDI from feces were performed to assess the infection. The subjects were divided into two groups. A group consisted of patients with CDI and the other group where the CDI was ruled out. The patients were evaluated for PI-IBS 6 months after the episode of CDI by Rome III IBS diagnostic questionnaire and the Bristol Stool Form Scale. In these patients CDI recurrence was ruled out by PCR; patients were retested. Severity of CDI was stratified according to the need for hospitalization or not. Other evaluated parameters for severity at patients were the level of serum creatinin, C-reactive protein (CRP) and white blood cell count (WBC). The questionnaires were paper printed and directly filled in by the subjects.Results The response rate to the questionnaire was 100%. During the course of this study 31 patients died. Out of 38 patients, 37% (14 patients) were diagnosed with CDI. After CDI, 57% (8 patients) developed PI-IBS and 43% (6 patients) where without PI-IBS with a relative risk (RR) of 2.29 (95 % confidence interval CI 0.99 – 5.23), p=0.04. In the group of patients with a severe form of CDI, 90% (9 patients) developed PI-IBS with a RR of 2.72 (95% CI 0.80 – 9.24), p=0.04, compared to the group of patients with light and moderate forms CDI.Conclusion Our study shows that, 6 months after CDI, PI-IBS develops in 57% patients, higher than in the control group where CDI was ruled out by PCR (43%), statitstically significant (p=0.04). The severity of CDI was a risk factor for PI-IBS, 90% of patients with severe forms of CDI developed PI-IBS.
Background and Aim Post-Infectious Irritable Bowel Syndrome (PI-IBS) is a common complication of Clostridium difficile infection (CDI). The objectives of this study were to asses the risk of PI-IBS following a CDI. We also evaluated if there is a correlation between the onset of PI-IBS and the severity of CDI. Methods The study group consisted of 69 patients consecutively admitted in a tertiary center with an acute gastroenteritis episode, suspected of having a Clostridium difficile infection. PCR for CDI from feces were performed to assess the infection. The subjects were divided into two groups. A group consisted of patients with CDI and the other group where the CDI was ruled out. The patients were evaluated for PI-IBS 6 months after the episode of CDI by Rome III IBS diagnostic questionnaire and the Bristol Stool Form Scale. Severity of CDI was stratified according to the need for hospitalization or not. The questionnaires were paper printed and directly filled in by the subjects. Results The response rate to the questionnaire was 100%. During the course of this study 31 patients died. Out of 38 patients, 37% (14 patients) were diagnosed with CDI. After CDI, 57% (8 patients) developed PI-IBS and 43% (6 patients) where without PI-IBS with a relative risk (RR) of 2.29 (95 % confidence interval CI 0.99 – 5.23), p=0.04. In the group of patients with a severe form of CDI, 90% (9 patients) developed PI-IBS with a RR of 2.72 (95% CI 0.80 – 9.24), p=0.04, compared to the group of patients with light and moderate forms CDI. Conclusion Our study shows that, 6 months after CDI, PI-IBS develops in 57% patients, higher than in the control group where CDI was ruled out by PCR (43%), statitstically significant (p=0.04). The severity of CDI was a risk factor for PI-IBS, 90% of patients with severe forms of CDI developed PI-IBS.
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