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 25 June 2018

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News

Long-term prognosis in post-infection irritable bowel syndrome

Less than half of post-infective and non-infective irritable bowel syndrome patients will have recovered after 6 years finds a follow-up study examining the long-term natural history of post-infective IBS.

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Development of irritable bowel syndrome (IBS) following infective gastroenteritis accounts for approximately 10% of unselected IBS patients.

Until now, however, the long-term natural history of "post-infective IBS" (PI-IBS) has not been well defined.

Writing in the September issue of the journal Gut, researchers from Nottingham, England, present data on original bowel habit, episodes of gastroenteritis, mental health history, and subsequent bowel habits at 6 years in 192 individuals.

A total of 436 individuals, who had previously responded to a questionnaire on their bowel habits following an acute episode of gastroenteritis, were sent a further questionnaire about their current bowel habits and physical and mental health 6 years after their initial illness.

Of the 436 people sent questionnaires, 192 responded with complete data, and 14 cases of PI-IBS were identified.

In addition, 13 patients were also identified who had IBS prior to infection (previous IBS).

Over the 6-year follow-up period there were also 20 "new non-infective IBS cases" (new IBS).

The strongest risk factor for developing any type of IBS was female sex (relative risk 2.2).

Compared with new IBS, those with PI-IBS had significantly more days with loose stools but a similar number of days with pain, urgency, and bloating.

6 of 14 (43%) PI-IBS and 4 of 13 (31%) previous IBS patients recovered by 6 years.

Of 27 IBS patients followed for the whole 6 years, only 1 in 8 with a history of anxiety or depression recovered, compared with 9 in 19 without such a history.

Female sex - strongest risk factor for developing IBS
Gut

Concluding on behalf of his fellow authors, Dr K. R. Neal said that PI-IBS differs from non-infective IBS by having more diarrheal features.

Dr Neal added, "Less than half of both PI-IBS and non-infective IBS cases recover over 6 years."

"A history of anxiety and depression severe enough to warrant treatment may impair recovery but larger numbers are needed to prove this."

Gut 2002; 51(3): 410-413
14 August 2002

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