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Systematic review with meta-analysis: post-infectious irritable bowel syndrome after travellers' diarrhoea.
Aliment Pharmacol Ther. 2015 Jun; 41(11):1029-37.AP

Abstract

BACKGROUND

Gastrointestinal infection is known as a risk factor for the development of the irritable bowel syndrome (post-infectious irritable bowel syndrome, PI-IBS). The incidence of PI-IBS ranges between 3% and over 30% of people after infectious gastroenteritis.

AIM

To perform a meta-analysis pools and report data concerning the relative risk (RR) of PI-IBS after TD.

METHODS

Database search using Medline through PubMed, Scopus, EBM Reviews (Cochrane Database of Systematic Reviews) and PsycINFO was performed to identify relevant studies. Those that met the inclusion criteria were pooled. A random effects model (Mantel-Haenszel) was performed.

RESULTS

Six eligible studies were found. In three of six studies, the authors reported a statistically significant association of TD and PI-IBS. The pooled RR was 3.35 (95% CI: 2.22-5.05) with a significant overall effect (P < 0.00001). Overall PI-IBS incidence was 5.4% in TD subjects and 1.4% in healthy subjects. There was no significant heterogeneity within the pooled studies (I(2) = 5%). Self-reported TD alone resulted in an over 1.5-fold RR for PI-IBS compared to laboratory-confirmed TD [RR 3.90 (95% CI: 2.35-6.49) vs. RR 2.42 (95% CI: 1.22-4.78)].

CONCLUSIONS

There is a strong association between travellers' diarrhoea and post-infectious irritable bowel syndrome. Self-reports of exposure seem to result in a higher post-infectious irritable bowel syndrome occurrence than laboratory-confirmed cases of travellers' diarrhoea, but further studies are needed to confirm this finding. Finally, potential influences of the selection of an appropriate study population on post-infectious irritable bowel syndrome epidemiology are discussed.

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  • Publisher Full Text

    • Authors+Show Affiliations

    Schwille-Kiuntke J
    Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
    Mazurak N
    No affiliation info available
    Enck P
    No affiliation info available

    MeSH

    DiarrheaGastritisHumansIncidenceIrritable Bowel SyndromeRisk FactorsTravel

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    25871571

    Citation

    Schwille-Kiuntke, J, et al. "Systematic Review With Meta-analysis: Post-infectious Irritable Bowel Syndrome After Travellers' Diarrhoea." Alimentary Pharmacology & Therapeutics, vol. 41, no. 11, 2015, pp. 1029-37.
    Schwille-Kiuntke J, Mazurak N, Enck P. Systematic review with meta-analysis: post-infectious irritable bowel syndrome after travellers' diarrhoea. Aliment Pharmacol Ther. 2015;41(11):1029-37.
    Schwille-Kiuntke, J., Mazurak, N., & Enck, P. (2015). Systematic review with meta-analysis: post-infectious irritable bowel syndrome after travellers' diarrhoea. Alimentary Pharmacology & Therapeutics, 41(11), 1029-37. https://doi.org/10.1111/apt.13199
    Schwille-Kiuntke J, Mazurak N, Enck P. Systematic Review With Meta-analysis: Post-infectious Irritable Bowel Syndrome After Travellers' Diarrhoea. Aliment Pharmacol Ther. 2015;41(11):1029-37. PubMed PMID: 25871571.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Systematic review with meta-analysis: post-infectious irritable bowel syndrome after travellers' diarrhoea. AU - Schwille-Kiuntke,J, AU - Mazurak,N, AU - Enck,P, Y1 - 2015/04/13/ PY - 2014/11/17/received PY - 2014/12/11/revised PY - 2015/03/04/revised PY - 2015/03/24/revised PY - 2015/03/25/accepted PY - 2015/4/15/entrez PY - 2015/4/15/pubmed PY - 2015/11/4/medline SP - 1029 EP - 37 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 41 IS - 11 N2 - BACKGROUND: Gastrointestinal infection is known as a risk factor for the development of the irritable bowel syndrome (post-infectious irritable bowel syndrome, PI-IBS). The incidence of PI-IBS ranges between 3% and over 30% of people after infectious gastroenteritis. AIM: To perform a meta-analysis pools and report data concerning the relative risk (RR) of PI-IBS after TD. METHODS: Database search using Medline through PubMed, Scopus, EBM Reviews (Cochrane Database of Systematic Reviews) and PsycINFO was performed to identify relevant studies. Those that met the inclusion criteria were pooled. A random effects model (Mantel-Haenszel) was performed. RESULTS: Six eligible studies were found. In three of six studies, the authors reported a statistically significant association of TD and PI-IBS. The pooled RR was 3.35 (95% CI: 2.22-5.05) with a significant overall effect (P < 0.00001). Overall PI-IBS incidence was 5.4% in TD subjects and 1.4% in healthy subjects. There was no significant heterogeneity within the pooled studies (I(2) = 5%). Self-reported TD alone resulted in an over 1.5-fold RR for PI-IBS compared to laboratory-confirmed TD [RR 3.90 (95% CI: 2.35-6.49) vs. RR 2.42 (95% CI: 1.22-4.78)]. CONCLUSIONS: There is a strong association between travellers' diarrhoea and post-infectious irritable bowel syndrome. Self-reports of exposure seem to result in a higher post-infectious irritable bowel syndrome occurrence than laboratory-confirmed cases of travellers' diarrhoea, but further studies are needed to confirm this finding. Finally, potential influences of the selection of an appropriate study population on post-infectious irritable bowel syndrome epidemiology are discussed. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/25871571/full_citation L2 - https://doi.org/10.1111/apt.13199 DB - PRIME DP - Unbound Medicine ER -