Original articleGastrointestinal Symptoms After Infectious Diarrhea: A Five-Year Follow-Up in a Swedish Cohort of Adults
Section snippets
Materials and Methods
All the 851 patients from the original study8 were included in the present study of sufferers from a diarrheal disease of proven or strongly suspected infectious etiology (infectious diarrhea). Of these, 134 persons could not be reached for the following reasons: 107 had died, 14 had a non-traceable social security number, and 13 had no known address or a protected identity. At the end of 2002, the remaining 717 persons were sent a questionnaire to fill in and return by mail. The questionnaire
Results
A total of 508 patients (71%) returned the study questionnaire. Of these, 173 were excluded because of pre-existing symptoms compatible with FBD or other GI diseases, and 2 were in a physical condition that prevented them from answering the questionnaire. This meant that 333 previously healthy patients, denying any GI problems before the infectious diarrhea, formed the study population. Forty-one (12%) patients had developed persistent (3 months or longer) GI symptoms, and 31 (9%) patients
Discussion
Our study adds some new aspects to the available information regarding the development and long-term persistence of GI symptoms after an infectious diarrhea in previously healthy adults. Five years later, we found that 12% had had symptoms with a sufficient duration to qualify for a diagnosis of an FBD. From a prognostic viewpoint, 24% recovered to normal bowel habits during the study period, which is slightly worse than what has been reported in a long-term study by Neal et al.2 Female gender
References (22)
Postinfectious irritable bowel syndrome
Gastroenterology
(2003)- et al.
Dyspepsia and irritable bowel syndrome after a Salmonella gastroenteritis outbreak: one-year follow-up cohort study
Gastroenterology
(2005) - et al.
Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome
Am J Gastroenterol
(2003) - et al.
Incidence and epidemiology of irritable bowel syndrome after a large waterborne outbreak of bacterial dysentery
Gastroenterology
(2006) - et al.
Does bacterial gastroenteritis predispose people to functional gastrointestinal disorders?a prospective, community-based, case-control study
Am J Gastroenterol
(2003) - et al.
Gastroparesis after a presumed viral illness: clinical and laboratory features and natural history
Mayo Clin Proc
(1990) - et al.
Postviral gastroparesis: presentation, treatment, and outcome
J Pediatr
(1997) - et al.
Irritable bowel syndrome: post salmonella infection
J Infect
(1994) - et al.
Psychometric scores and persistence of irritable bowel after infectious diarrhoea
Lancet
(1996) - et al.
Relative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS
Gastroenterology
(2003)
Prognosis in post-infective irritable bowel syndrome: a six year follow up study
Gut
Cited by (62)
Post-infection Irritable Bowel Syndrome
2021, Gastroenterology Clinics of North AmericaInfections associated with irritable bowel syndrome
2019, Gastrointestinal Diseases and Their Associated InfectionsRome Foundation Working Team Report on Post-Infection Irritable Bowel Syndrome
2019, GastroenterologyPre-travel advice at a crossroad: Medical preparedness of travellers to South and Southeast-Asia - The Hamburg Airport Survey
2017, Travel Medicine and Infectious DiseaseCitation Excerpt :Hence azithromycin or rifaximin may be more sensible choices for travellers to Asia – if one chooses to equip travellers for self-treatment [28]. Due to potential untoward effects of antibiotic self-treatment (such as increased colonization with resistant bacteria or disturbances of the gut microbiome [29–32]) it has been proposed to reserve it for special traveller populations with a high risk of complications, such as travellers with inflammatory bowel disease or with immunosuppressive conditions [33]. In Germany and Switzerland, stand-by-emergency treatment of malaria is recommended for low risk areas including most parts of South and Southeast Asia [5].
Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis
2017, GastroenterologyCitation Excerpt :Fever and weight loss with IE were not observed to be risk factors for PI-IBS. Based on 7 studies,17,23,31,40,44,45,59 antibiotic exposure at time of PI-IBS was associated with an increased odds of developing PI-IBS (OR, 1.69; 95% CI, 1.20−2.37) (I2 = 32%). Thirteen studies reported phenotype of new-onset IBS after IE.
Role of translocated bacterial flagellin in monocyte activation among individuals with chronic HIV-1 infection
2015, Clinical ImmunologyCitation Excerpt :The first three groups form part of an observational cohort where plasma, serum and peripheral blood mononuclear cells (PBMCs) were isolated [25]. The material from the diarrhea patients, frozen serum samples, was from a large prospective enteropathogen study at Karolinska University Hospital [26,27] (the causative agents identified were Salmonella (n = 10), Escherichia coli/Shigella (n = 7), Campylobacter (n = 5) and Clostridium difficile (n = 5)). Ethical permission was obtained from the Regional Ethical Review Board Stockholm (Dnr 2009-1485-31-3) and the Ethics Committee of Karolinska University Hospital Huddinge (Dnr 399/99), respectively.