Irritable Bowel Syndrome Among a Cohort of European Travelers to Resource‐Limited Destinations

Pitzurra, Raffaela; Fried, Michael; Rogler, Gerhard; Rammert, Christina; Tschopp, Alois; Hatz, Christoph; Steffen, Robert; Mütsch, Margot

doi:10.1111/j.1708-8305.2011.00529.x

Cited by 51 publications

(45 citation statements)

References 29 publications

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“…Female sex was associated with a 2.2 times higher odds of developing PI-IBS (OR, 2.19; 95% CI, 1.57–3.07) based on 11 studies with extractable data. 4, 8, 17, 20, 23, 31, 35, 40, 44, 45, 50 Summary estimate shows substantial heterogeneity (I 2 =72%). Three of the 9 studies without extractable data also showed a significant association for female sex.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, we included 45 studies (n=21,421 participants with IE exposure) that reported the prevalence of PI-IBS. 4, 5, 7–13, 15–17, 20, 23, 29– 59 The flow diagram summarizing study identification and selection is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Three of the 9 studies without extractable data also showed a significant association for female sex. 5, 13, 56 Based on two studies, 17, 23 smoking was not associated with increased odds of PI-IBS (OR, 1.15; 95% CI, 0.90–1.46); an additional study without extractable data also observed a non-significant association. 42 …”

Section: Resultsmentioning

confidence: 99%

“…20, 22 However, other studies have reported a much lower prevalence of PI-IBS and have not confirmed the same risk factors to be associated with the development of PI-IBS. 23 Previous meta-analyses (most recent published in 2007) concluded that IE increases the risk of PI-IBS. However, it included few studies, with limited assessment of time-dependent point prevalence and relative risk of PI-IBS (compared to non-exposed controls), and could not comprehensively study host- and enteritis-related risk factors associated with PI-IBS development.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis

et al. 2017

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Background & Aims Foodborne illness affects 15% of the United States population each year and is a risk factor for irritable bowel syndrome (IBS). We evaluated risk of, risk factors for, and outcomes of IBS after infectious enteritis Methods We performed a systematic review of electronic databases from 1994 through August 31, 2015 to identify cohort studies of the prevalence of IBS 3 months or more after infectious enteritis. We used random effects meta-analysis to calculate the summary point prevalence of IBS after infectious enteritis, as well as relative risk (compared to individuals without infectious enteritis) and host- and enteritis-related risk factors. Results We identified 45 studies, comprising 21,421 individuals with enteritis, followed for 3 months–10 years for development of IBS. The pooled prevalence of IBS at 12 months after infectious enteritis was 10.1% (95% CI, 7.2–14.1) and at more than 12 months after infectious enteritis was 14.5% (95% CI, 7.7–25.5). Risk of IBS was 4.2-fold higher in patients who had infectious enteritis in the past 12 months than in individuals in those who had not (95% CI, 3.1–5.7); risk of IBS was 2.3-fold higher in individuals who had infectious enteritis longer than 12 months ago than in individuals who had not (95% CI, 1.8–3.0). Of patients with enteritis caused by protozoa or parasites, 41.9% developed IBS; of patients with enteritis caused bacterial infection, 13.8% developed IBS. Risk of IBS was significantly increased in women (odds ratio [OR], 2.2; 95% CI, 1.6–3.1) and with antibiotic exposure (OR, 1.7; 95% CI, 1.2–2.4), anxiety (OR, 2; 95% CI, 1.3–2.9), depression (OR, 1.5; 95% CI, 1.2–1.9), somatization (OR, 4.1; 95% CI, 2.7–6.0), neuroticism (OR, 3.3; 95% CI, 1.6–6.5), and clinical indicators of enteritis severity. There was a considerable level of heterogeneity among studies. Conclusion In a systematic review and meta-analysis, we found more than 10% of patients with infectious enteritis to later develop IBS; risk of IBS was 4-fold higher than in individuals who did not have infectious enteritis, although there was heterogeneity among studies analyzed. Women—particularly those with severe enteritis—are at increased risk for developing IBS, as are individuals with psychological distress and users of antibiotics during the enteritis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis

et al. 2017

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“…Post-infectious irritable bowel syndrome (PI-IBS) has become increasingly recognized as a major cause of travel-associated morbidity (16). In our analysis, MVRA travellers frequently presented with PI-IBS.…”

Section: Discussionmentioning

confidence: 99%

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

et al. 2014

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Background US residents make 60 million international trips annually. Family practice providers need to be aware of travel-associated diseases affecting this growing mobile population. Objective To describe demographics, travel characteristics and clinical diagnoses of US residents who present ill after international travel. Methods Descriptive analysis of travel-associated morbidity and mortality among US travellers seeking care at 1 of the 22 US practices and clinics participating in the GeoSentinel Global Surveillance Network from January 2000 to December 2012. Results Of the 9624 ill US travellers included in the analysis, 3656 (38%) were tourist travellers, 2379 (25%) missionary/volunteer/research/aid workers (MVRA), 1580 (16%) travellers visiting friends and relatives (VFRs), 1394 (15%) business travellers and 593 (6%) student travellers. Median (interquartile range) travel duration was 20 days (10–60 days). Pre-travel advice was sought by 45%. Hospitalization was required by 7%. Compared with other groups of travellers, ill MVRA travellers returned from longer trips (median duration 61 days), while VFR travellers disproportionately required higher rates of inpatient care (24%) and less frequently had received pre-travel medical advice (20%). Illnesses of the gastrointestinal tract were the most common (58%), followed by systemic febrile illnesses (18%) and dermatologic disorders (17%). Three deaths were reported. Diagnoses varied according to the purpose of travel and region of exposure. Conclusions Returning ill US international travellers present with a broad spectrum of travel-associated diseases. Destination and reason for travel may help primary health care providers to generate an accurate differential diagnosis for the most common disorders and for those that may be life-threatening.

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Traveler’s Diarrhea

Steffen

Hill

DuPont

2015

JAMA

Self Cite

291

156

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Irritable Bowel Syndrome Among a Cohort of European Travelers to Resource‐Limited Destinations

Abstract: In a large population of European travelers IBS had a lower incidence rate as compared to previous studies. Particular risk groups were identified; those may need to be protected.

Cited by 51 publications

References 29 publications

Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis

Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis

Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel

Traveler’s Diarrhea

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