Post-infection irritable bowel syndrome in the tropical and subtropical regions: Vibrio cholerae is a new cause of this well-known condition

Ghoshal, Uday C; Rahman, Mohammed M.

doi:10.1007/s12664-019-00959-2

Cited by 20 publications

(46 citation statements)

References 77 publications

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“…127 A range of bacterial pathogens have been implicated in PI-IBS, including Campylobacter jejuni, Escherichia coli, and Salmonella enterica serovar Typhimurium, 128 as well as Clostridioides difficile 129 and Vibrio cholerae. 130 Symptoms can persist for many years following the initial infection, 131 sometimes for more than a decade in some studies, 132 and the development of IBS in this context appears to be independent of other risk factors, such as age and sex. 133 Associations have also been demonstrated between viral infections such as norovirus, 134,135 and protozoal infections such as Giardia lamblia.…”

Section: [H2] Post-infection Ibsmentioning

confidence: 98%

Global burden of irritable bowel syndrome: trends, predictions and risk factors

Black

Ford

2020

Nat Rev Gastroenterol Hepatol

341

237

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Irritable bowel syndrome (IBS) is one of the most common disorders of gut-brain interaction worldwide and is defined according to patterns of gastrointestinal symptoms, as described by the Rome diagnostic criteria. However, these criteria, developed with reference to research conducted largely in Western populations, might be limited in their applicability to other countries and cultures. Epidemiological data show a wide variation in the prevalence of IBS globally and more rigorous studies are needed to accurately determine any differences that might exist between countries and potential explanations. The effect of IBS on the individual, in terms of their quality of life, and on healthcare delivery and society, in terms of economic costs, is considerable. Although the magnitude of these effects seems to be comparable between nations, their precise nature can vary based on the existence of societal and cultural differences. The pathophysiology of IBS is complex and incompletely understood; genetics, diet and the gut microbiome are all recognised risk factors, but the part they play might be influenced by geography and culture, and hence their relative importance might vary between countries. This Review aims to provide an overview of the burden of IBS in a global context, to discuss future implications for the care of people with IBS worldwide, and to identify key areas for further research.

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Section: [H2] Post-infection Ibsmentioning

confidence: 98%

Global burden of irritable bowel syndrome: trends, predictions and risk factors

Black

Ford

2020

Nat Rev Gastroenterol Hepatol

341

237

View full text Add to dashboard Cite

show abstract

“…Individual susceptibility to these so-called postinfectious functional gastrointestinal disorders (PI-FGIDs) involves genetic predisposition and the presence of pre-existing psychological disturbances such as anxiety and/or depression[ 55 , 56 ]. PI-FGIDs have also been associated with dysregulation of gut motility, visceral hypersensitivity, microbial dysbiosis, intestinal barrier dysfunction, bile acid malabsorption, and alterations in serotonin metabolism[ 54 , 57 ]. Current data suggest that the resolution of the SARS-CoV-2 infection may lead to persistent GI dysfunction resembling certain aspects of PI-FGIDs[ 17 ].…”

Section: Pathophysiological Mechanisms For Gi Symtoms In Covid-19mentioning

confidence: 99%

Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19

Jin

Singh

et al. 2021

WJG

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Gastrointestinal (GI) symptoms, such as diarrhea, abdominal pain, vomiting, and anorexia, are frequently observed in patients with coronavirus disease 2019 (COVID-19). However, the pathophysiological mechanisms connecting these GI symptoms to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections remain elusive. Previous studies indicate that the entry of SARS-CoV-2 into intestinal cells leads to downregulation of angiotensin converting enzyme 2 (ACE2) receptors resulting in impaired barrier function. While intestinal ACE2 functions as a chaperone for the amino acid transporter B0AT1, the B0AT1/ACE2 complex within the intestinal epithelium acts as a regulator of gut microbiota composition and function. Alternations to the B0AT1/ACE2 complex lead to microbial dysbiosis through increased local and systemic immune responses. Previous studies have also suggested that altered serotonin metabolism may be the underlying cause of GI disorders involving diarrhea. The findings of elevated plasma serotonin levels and high fecal calprotectin in COVID-19 patients with diarrhea indicate that the viral infection evokes a systemic inflammatory response that specifically involves the GI. Interestingly, the elevated proinflammatory cytokines correlate with elevated serotonin and fecal calprotectin levels further supporting the evidence of GI inflammation, a hallmark of functional GI disorders. Moreover, the finding that rectal swabs of COVID-19 patients remain positive for SARS-CoV-2 even after the nasopharynx clears the virus, suggests that viral replication and shedding from the GI tract may be more robust than that of the respiratory tract, further indicating fecal-oral transmission as another important route of viral spread. This review summarized the evidence for pathophysiological mechanisms (impaired barrier function, gut inflammation, altered serotonin metabolism and gut microbiota dysbiosis) underlying the GI symptoms in patients with COVID-19.

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“…Following acute infectious gastroenteritis, 7% to 9% subjects continue to experience GI dysfunction fulfilling the Rome criteria for IBS or FD or both though they did not have these disorders earlier 50, 51 . These conditions are called PI‐IBS and postinfection FD.…”

Section: Postinfection Irritable Bowel Syndromementioning

confidence: 99%

Marshall and Warren Lecture 2019: A paradigm shift in pathophysiological basis of irritable bowel syndrome and its implication on treatment

Ghoshal

2020

J of Gastro and Hepatol

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Irritable bowel syndrome (IBS), a common functional gastrointestinal disorder (FGID), has often been considered rather inappropriately as psychogenic in the past. Though psychological issues are important comorbidities in a proportion of IBS patients, the evidences are far from enough to label this condition as psychogenic only. In the recent past, evidences are emerging that underscores the concept supporting pure psychogenic theory of IBS and suggest this disorder to be rather microorganic. Accordingly, a move of Rome IV Committee attempting to delete the term "functional" and designating these to be disorders of "gut-brain interaction" rather than that of "brain-gut interaction," it emphasizes the importance of the gut over the brain in the pathogenesis. The introduction of the concept of multidimensional clinical profile in Rome IV requires attention to diagnostic category of FGID, overlap, severity, psychological issues, and physiological dysfunction or biomarkers; this attempts to recognize clinical variability and multidimensionality of pathophysiology and management of these disorders. The recognition of the biological factors in the pathogenesis of IBS is a significant paradigm shift in the recent time. This is somewhat similar to the progress in the pathogenesis of peptic ulcer disease from psychological factor to acid to Helicobacter pylori infection. It is expected that in the near future, therapeutic modalities targeting the different pathogenic mechanisms of different subtypes of IBS may bring revolution in management of the disorder.

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Post-infection irritable bowel syndrome in the tropical and subtropical regions: Vibrio cholerae is a new cause of this well-known condition

Cited by 20 publications

References 77 publications

Global burden of irritable bowel syndrome: trends, predictions and risk factors

Global burden of irritable bowel syndrome: trends, predictions and risk factors

Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19

Marshall and Warren Lecture 2019: A paradigm shift in pathophysiological basis of irritable bowel syndrome and its implication on treatment

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