Irritable bowel syndrome following gastroenteritis is well recognized.
In this study, a team of researchers from England determined whether postinfective IBS (PI-IBS) has features that differ from those of IBS patients with no history of infection.
They assessed 75 consecutive IBS outpatients and 36 healthy control subjects.
|Diarrhea predominance occurred in 70% of postinfective irritable bowel syndrome patients.|
|American Journal of Gastroenterology|
Subjects completed a questionnaire detailing symptoms, mode of onset, and previous psychiatric history.
In addition, all subjects underwent a full diagnostic workup including rectal biopsy. This included immunostaining and quantification for lamina propria or intraepithelial T lymphocytes, serotonin-containing enterochromaffin (EC), and mast cells.
The investigators divided patients according to onset of symptoms into PI-IBS or non–PI-IBS patients.
The team found that diarrhea predominance occurred in 70% of PI-IBS patients, compared with 42% in non–PI-IBS patients.
They also determined that a history of previous treatment for anxiety or depression was present in 26% of PI-IBS patients, compared to 54% of non–PI-IBS.
Biopsy results for all patients were normal using conventional criteria.
However, quantification revealed that PI-IBS showed increased EC cells, compared to those of non–PI-IBS patients and controls.
Furthermore, lamina propria T lymphocytes were increased in PI-IBS and non–PI-IBS patients, compared to controls.
They found that mast cells were also increased in non–PI-IBS patients, compared to controls.
Simon Dunlop's team concluded, "Individuals with PI-IBS are a clinically distinct subgroup characterized by diarrheal symptoms, less psychiatric illness, and increased serotonin-containing EC cells compared to those with non–PI-IBS".