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Postinfectious irritable bowel syndrome.
Gastroenterology. 2009 May; 136(6):1979-88.G

Abstract

Approximately 1 in ten patients with irritable bowel syndrome (IBS) believe their IBS began with an infectious illness. Prospective studies have shown that 3% to 36% of enteric infections lead to persistent new IBS symptoms; the precise incidence depends on the infecting organism. Whereas viral gastroenteritis seems to have only short-term effects, bacterial enteritis and protozoan and helminth infections are followed by prolonged postinfective IBS (PI-IBS). Risk factors for developing PI-IBS include, in order of importance, prolonged duration of initial illness, toxicity of infecting bacterial strain, smoking, mucosal markers of inflammation, female gender, depression, hypochondriasis, and adverse life events in the preceding 3 months. Age older than 60 years might protect against PI-IBS, whereas treatment with antibiotics has been associated with increased risk. The mechanisms that cause PI-IBS are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. Adverse psychological factors contribute to persistent low-grade inflammation. The prognosis for patients with PI-IBS is somewhat better than for those with unselected IBS, but PI-IBS can still take years to resolve. There are no specific treatments for PI-IBS; these should be tailored to the predominant bowel disturbance, which is most frequently diarrhea.

Authors+Show Affiliations

Nottingham Digestive Diseases Centre Biomedical Research Unit, University Hospital, Nottingham, England. robin.spiller@nottingham.ac.ukNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

19457422

Citation

Spiller, Robin, and Klara Garsed. "Postinfectious Irritable Bowel Syndrome." Gastroenterology, vol. 136, no. 6, 2009, pp. 1979-88.
Spiller R, Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009;136(6):1979-88.
Spiller, R., & Garsed, K. (2009). Postinfectious irritable bowel syndrome. Gastroenterology, 136(6), 1979-88. https://doi.org/10.1053/j.gastro.2009.02.074
Spiller R, Garsed K. Postinfectious Irritable Bowel Syndrome. Gastroenterology. 2009;136(6):1979-88. PubMed PMID: 19457422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postinfectious irritable bowel syndrome. AU - Spiller,Robin, AU - Garsed,Klara, Y1 - 2009/05/07/ PY - 2008/12/05/received PY - 2009/02/09/revised PY - 2009/02/17/accepted PY - 2009/5/22/entrez PY - 2009/5/22/pubmed PY - 2009/6/10/medline SP - 1979 EP - 88 JF - Gastroenterology JO - Gastroenterology VL - 136 IS - 6 N2 - Approximately 1 in ten patients with irritable bowel syndrome (IBS) believe their IBS began with an infectious illness. Prospective studies have shown that 3% to 36% of enteric infections lead to persistent new IBS symptoms; the precise incidence depends on the infecting organism. Whereas viral gastroenteritis seems to have only short-term effects, bacterial enteritis and protozoan and helminth infections are followed by prolonged postinfective IBS (PI-IBS). Risk factors for developing PI-IBS include, in order of importance, prolonged duration of initial illness, toxicity of infecting bacterial strain, smoking, mucosal markers of inflammation, female gender, depression, hypochondriasis, and adverse life events in the preceding 3 months. Age older than 60 years might protect against PI-IBS, whereas treatment with antibiotics has been associated with increased risk. The mechanisms that cause PI-IBS are unknown but could include residual inflammation or persistent changes in mucosal immunocytes, enterochromaffin and mast cells, enteric nerves, and the gastrointestinal microbiota. Adverse psychological factors contribute to persistent low-grade inflammation. The prognosis for patients with PI-IBS is somewhat better than for those with unselected IBS, but PI-IBS can still take years to resolve. There are no specific treatments for PI-IBS; these should be tailored to the predominant bowel disturbance, which is most frequently diarrhea. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/19457422/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(09)00361-8 DB - PRIME DP - Unbound Medicine ER -