Half of Patients Show Prolonged IBS Post-Gastroenteritis

TOPLINE:

Acute gastroenteritis increases the odds of developing functional dyspepsia (FD) and irritable bowel syndrome (IBS), with the latter lasting 1-4 years in half of patients after the infection.

METHODOLOGY:

• Disorders of gut-brain interaction, such as IBS and FD, may arise after acute infectious gastroenteritis, but data on their postinfection prevalence and persistence and the influence of pathogen type are lacking.
• Researchers conducted a systematic review and meta-analysis of 47 observational studies investigating the prevalence of postinfection IBS (PI-IBS) or postinfection FD (PI-FD) after acute gastroenteritis.
• The studies involved 28,170 participants across 27 countries. Only studies with patient follow-up of 3 or more months were included.
• The research team used a random effects model to estimate PI-IBS and PI-FD prevalence and odds ratios (ORs).

TAKEAWAY:

• Overall, 14.5% of participants with acute gastroenteritis developed PI-IBS, and 12.7% developed PI-FD.
• Patients with acute gastroenteritis had 4.3 times higher odds for PI-IBS and three times higher odds for PI-FD than nonexposed control individuals.
• PI-IBS rates persisted in 52.3% of participants at 1-4 years of follow-up and in 39.8% at more than 5 years. There were insufficient data to determine the persistence of FD.
• PI-IBS was most associated with parasites (prevalence, 30.1%), followed by bacteria (18.3%) and viruses (10.7%).
• In available studies, Campylobacter was associated with the highest PI-IBS prevalence (20.7%), though Proteobacteria and SARS-CoV-2 had the highest odds for PI-IBS (OR, 5.4 for both). The prevalence of PI-FD was 10% for SARS-CoV-2 and 13.6% for bacteria, with the highest prevalence after Enterobacteriaceae infection (19.4%).

IN PRACTICE:

“Generally, as acute gastroenteritis is a common disorder worldwide, our findings may be relevant for public health, and physicians should pay heed if their patients present with a recent episode of infectious gastroenteritis,” the authors wrote. “Moreover, physicians should be aware that some microbes with pro-inflammatory characteristics may be associated with PI-IBS or PI-FD.”

SOURCE:

The study, with first author Serena Porcari, from the Department of Translational Medicine and Surgery at the Universita Cattolica del Sacro Cuore Facolta di Medicina e Chirurgia, Rome, was published online in Gut.

LIMITATIONS:

The study was limited by heterogeneity across the study designs, definitions of inflammatory bowel disease and FD, sample sizes, and length of follow-up periods. In addition, most studies came from Europe and North America, with limited data from areas with a high prevalence of acute gastroenteritis, such as the Asia-Pacific region and Africa.

DISCLOSURES:

The study was supported by the Fondazione Roma, Italian Ministry of Health, Italian Ministry of University and Research, and Italian Ministry of Research. Several authors reported consultancy, speaker, and advisory fees from numerous pharmaceutical companies.