Postinfectious irritable bowel syndrome (IBS) is a common clinical phenomenon.
Dr John Marshall and colleagues from Canada defined its incidence and epidemiology.
The doctors conducted a cohort study after a municipal water contamination led to an outbreak of Escherichia coli and Campylobacter jejuni gastroenteritis.
The team of doctors invited local residents to undergo structured assessments at research clinics established 2 years after the outbreak.
Permanent adult residents with no prior history of inflammatory bowel disease or irritable bowel syndrome were eligible.
|Independent risk factors for postinfectious IBS included weight loss|
Standardized questionnaires defined past and current health.
The doctors divided the cohort into 3 groups.
Group 1 included 701 controls without gastroenteritis.
The team assessed 464 subjects in Group 2 who had clinically suspected gastroenteritis.
Group 3 involved 904 subjects with only self-reported gastroenteritis that could not be substantiated by another source.
A modified Bowel Disease Questionnaire identified irritable bowel syndrome according to Rome criteria.
The team characterized the incidence and epidemiology of postinfectious irritable bowel syndrome.
Risk factors were assessed using multiple logistic regression.
The team involved 2069 eligible study participants.
The doctors found that Rome I criteria were met by 10% of controls vs 28% with self-reported gastroenteritis, and 36% with clinically suspected gastroenteritis.
Independent risk factors for postinfectious irritable bowel syndrome included younger age, female sex, and bloody stools.
The team observed that abdominal cramps, weight loss, and prolonged diarrhea were also independent risk factors.
Postinfectious irritable bowel syndrome was more likely than sporadic irritable bowel syndrome to show diarrhea-predominant features.
Dr Marshall's team concludes, “Postinfectious irritable bowel syndrome is common after gastroenteritis from water contamination and often is diarrhea-predominant.”
“Characteristics of the acute illness identify patients at increased risk for postinfectious irritable bowel syndrome.”