Relative risk of irritable bowel syndrome following acute gastroenteritis and associated risk factors

Abstract

SUMMARYA prospective cohort study using electronic medical records was undertaken to estimate the relative risk (RR) of irritable bowel syndrome (IBS) following acute gastroenteritis (GE) in primary-care patients in The Netherlands and explore risk factors. Patients aged 18-70 years who consulted for GE symptoms from 1998 to 2009, met inclusion/exclusion criteria and had at least 1 year of follow-up data were included. Patients with non-GE consultations, matched by age, gender, consulting practice and time of visit, served as the reference group. At 1 year, 1·2% of GE patients (N = 2428) had been diagnosed with IBS compared to 0·3% of the reference group (N = 2354). GE patients had increased risk of IBS [RR 4·85, 95% confidence interval (CI) 2·02-11·63]. For GE patients, concomitant cramps and history of psycho-social consultations were significantly associated with increased risk. GE patients had increased risk of IBS up to 5 years post-exposure (RR 5·40, 95% CI 2·60-11·24), suggesting there may be other contributing factors.

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

“…Out of the 45 studies, 41 studies used online or mailed survey questionnaires or in person or telephone interviews and 4 studies were conducted using electronic databases. Of the ones using databases, two used ICD codes alone, 7, 33 one used ICD codes plus clinician documentation 17 and one used ICD codes plus IBS confirmation by a physician. 16 The survey response rate was variable (36–96%).…”

“…Exclusion of pre enteritis IBS was specified in 35 of 45 studies and IBD in 26 of the 45 studies. Additionally, one study excluded IE episodes within 12 m before the current IE episode 33 and one excluded patients with another IE episode anytime in the past. 16 …”

“…Abdominal pain during IE was assessed in 15 studies as a risk factor for PI-IBS development, 9 of which found a significant association, 4 of which 10, 20, 31, 33 had data for summarization (OR, 3.26; 95% CI, 1.30–8.14). Summary estimate shows considerable heterogeneity (I 2 =86%).…”

Incidence of irritable bowel syndrome and chronic fatigue following GI infection: a population-level study using routinely collected claims data

“…The adjusted relative risk of IBS due to bacterial gastroenteritis was 2.2, with an increased risk likewise shown for female sex, psychological disorders (depression, anxiety, stress, sleeping disorder) and other GI comorbidity. A second study by Kowalcyk et al  analysed data from the Primary Care Network Utrecht in the Netherlands 52. A cohort of 2464 patients consulting with gastroenteritis was matched by age, sex and month of consultation with a group of randomly selected patients consulting for other conditions.…”

Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies

“…4 The risk factors that emerged from Klem's systematic review of post-infectious IBS incidence included the severity and duration of the enteritis and younger age, female sex, smoking status, anxiety, depression, somatisation and neuroticism. [5][6][7][8][9] The aim of this review is to identify what is currently known of the incidence and risk factors for developing new onset IBS in population-based cohorts to complement what is already established regarding post-infectious IBS. [5][6][7][8][9] The aim of this review is to identify what is currently known of the incidence and risk factors for developing new onset IBS in population-based cohorts to complement what is already established regarding post-infectious IBS.…”