Post-infectious irritable bowel syndrome in patients with Shigella infection

JI, SANGWON
PARK, HYOJIN
LEE, DOKYONG
SONG, YOUNG KOO
CHOI, JAE PHIL
LEE, SANG-IN

Yonsei Institute of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

Correspondence: Dr Hyojin Park, Department of Internal Medicine, Yongdong Severance Hospital, Yonsei University College of Medicine, Yongdong PO Box 1217, Seoul 135-270, Korea. Email: [email protected]

Accepted for publication 30 April 2004.

Journal of Gastroenterology & Hepatology 20(3):p 381-386, March 2005.

Background and Aims

Bacterial gastroenteritis has been known as a risk factor of irritable bowel syndrome (IBS). Several risk factors of post-infectious IBS (PI-IBS) have been documented. The aims of this study were to verify the role of bacterial gastroenteritis in the development of IBS and the risk factors for the development of PI-IBS. The clinical course of PI-IBS was also investigated.

Methods

We recruited 143 patients with shigellosis during its outbreak and 113 controls. Both groups were followed up for 12 months. Bowel symptoms were evaluated by use of questionnaires at 3, 6 and 12 months after the initial recruitment.

Results

Complete data were obtained from 101 patients (70.6%) and 102 healthy controls (90.3%). At 12 months, 15 patients and six controls had IBS (adjusted OR; 2.9, 95% CI; 1.1–7.9). Of the 15 patients, five had IBS symptoms consistently for 12 months, three did not have IBS symptoms initially and seven had fluctuating bowel symptoms. The duration of diarrhea was an independent risk factor of PI-IBS.

Conclusions

Bacterial gastroenteritis is a risk factor of IBS and the duration of diarrhea as the index of severity of initial illness is an independent risk factor of PI-IBS. The clinical course of PI-IBS is variable over the 1 year of follow-up.