The Incidence of Irritable Bowel Syndrome Among Community Subjects With Previous Acute Enteric Infection

Abstract

The purpose of this study was to determine the incidence of postinfectious irritable bowel syndrome (IBS) among community subjects with positive stool studies. This was a prospective cohort study whereby all individuals with stool-positive acute enteric infection (AEI) were recruited from 3 health regions in Ontario, Canada. Each person completed questionnaires regarding preinfectious bowel habit and their bowel habit 3 months postinfection. Manning and Rome I criteria were used to diagnose irritable bowel syndrome. Two hundred thirty-one patients participated. Forty had preexisting IBS and were excluded. Of the remaining 191 patients, 7 developed irritable bowel syndrome, for an incidence of 3.7% (95% confidence interval: 1.0-6.3%). Fever during AEI was the only identifiable risk factor for developing postinfectious IBS (odds ratio, 11.96; P = .02). The incidence of postinfectious IBS in community subjects is 3.7%. Fever during the AEI may be an important risk factor for this condition.

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

“…The aetiology, pathogenesis and prognosis of IBS are not well understood and there is no widely effective treatment [4][5][6][7][8][9].…”

“…Campylobacter, Shigella, Salmonella and Escherichia coli infections as well as viral agents, including norovirus, and parasites have been associated with PI-IBS [5,21,[23][24][25]. It has been hypothesized that exposure to an infectious organism alters gut flora, increases intestinal permeability and triggers chronic inflammation, inducing PI-IBS [3,9,26,27].…”

Review: Do patients with functional gastrointestinal disorders have an altered gut flora?

“…Very recently, an outbreak of viral gastroenteritis was associated with the new onset of an IBS-type syndrome in 24% of affected subjects when interviewed 3 months later; subsequent follow-up suggested that postviral IBS was more transient than its bacterial counterpart . Postinfectious IBS may explain only a minority of cases of IBS (1-6.7% in one recent study [Borgaonkar et al 2006]) but it does represent a clear link between exposure to an environmental agent, inflammation and IBS in predisposed individuals (Figure 2). …”

Irritable bowel syndrome; update on pathophysiology and management

“…Post-infectious IBS may explain only a minority of cases of IBS [1-6.7% in one recent study (38)] but it does represent a clear link between exposure to an environmental agent, inflammation and IBS in predisposed individuals.…”