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Erschienen in: Indian Journal of Gastroenterology 2/2019

04.04.2019 | Original Article

A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India

verfasst von: Prasanta Kumar Parida, Debakanta Mishra, Girish Kumar Pati, Preetam Nath, Kaibalya Ranjan Dash, Sambit Kumar Behera, Suryakanta Parida, Chitta Ranjan Khatua, Subhendu Panigrahi, Amarendra Mahapatra, Hemant Kumar Khuntia, Shivaram Prasad Singh

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 2/2019

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Abstract

Background and Aim

Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score.

Methods

This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested.

Results

Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively.

Conclusion

One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.
Literatur
1.
Zurück zum Zitat Sperber AD, Dumitrascu D, Fukudo S, et al. The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut. 2017;66:1075–82.CrossRefPubMed Sperber AD, Dumitrascu D, Fukudo S, et al. The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome Foundation working team literature review. Gut. 2017;66:1075–82.CrossRefPubMed
2.
Zurück zum Zitat Rahman MM, Mahadeva S, Ghoshal UC. Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: a review. World J Gastroenterol. 2017;23:6788–801.CrossRefPubMedPubMedCentral Rahman MM, Mahadeva S, Ghoshal UC. Epidemiological and clinical perspectives on irritable bowel syndrome in India, Bangladesh and Malaysia: a review. World J Gastroenterol. 2017;23:6788–801.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130:1377–90.CrossRefPubMed Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006;130:1377–90.CrossRefPubMed
4.
Zurück zum Zitat Marshall JK, Thabane M, Borgaonkar MR, James C. Postinfectious irritable bowel syndrome after a food-borne outbreak of acute gastroenteritis attributed to a viral pathogen. Clin Gastroenterol Hepatol. 2007;5:457–60.CrossRefPubMed Marshall JK, Thabane M, Borgaonkar MR, James C. Postinfectious irritable bowel syndrome after a food-borne outbreak of acute gastroenteritis attributed to a viral pathogen. Clin Gastroenterol Hepatol. 2007;5:457–60.CrossRefPubMed
5.
Zurück zum Zitat Chaudhary NA, Truelove SC. The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases. Q J Med. 1962;31:307–22.PubMed Chaudhary NA, Truelove SC. The irritable colon syndrome. A study of the clinical features, predisposing causes, and prognosis in 130 cases. Q J Med. 1962;31:307–22.PubMed
6.
Zurück zum Zitat Dunlop SP, Jenkins D, Spiller RC. Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome. Am J Gastroenterol. 2003;98:1578–83.CrossRefPubMed Dunlop SP, Jenkins D, Spiller RC. Distinctive clinical, psychological, and histological features of postinfective irritable bowel syndrome. Am J Gastroenterol. 2003;98:1578–83.CrossRefPubMed
7.
Zurück zum Zitat Thabane M, Simunovic M, Akhtar-Danesh N, Marshall JK. Development and validation of a risk score for post-infection irritable bowel syndrome. Am J Gastroenterol. 2009;104:2267–74.CrossRefPubMed Thabane M, Simunovic M, Akhtar-Danesh N, Marshall JK. Development and validation of a risk score for post-infection irritable bowel syndrome. Am J Gastroenterol. 2009;104:2267–74.CrossRefPubMed
8.
Zurück zum Zitat GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17:909–48.CrossRef GBD Diarrhoeal Diseases Collaborators. Estimates of global, regional, and national morbidity, mortality, and aetiologies of diarrhoeal diseases: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Infect Dis. 2017;17:909–48.CrossRef
9.
Zurück zum Zitat Gwee KA, Lu CL, Ghoshal UC. Epidemiology of irritable bowel syndrome in Asia: something old, something new, something borrowed. J Gastroenterol Hepatol. 2009;24:1601–7.CrossRefPubMed Gwee KA, Lu CL, Ghoshal UC. Epidemiology of irritable bowel syndrome in Asia: something old, something new, something borrowed. J Gastroenterol Hepatol. 2009;24:1601–7.CrossRefPubMed
10.
Zurück zum Zitat Jung IS, Kim HS, Park H, Lee SI. The clinical course of post irritable bowel syndrome: a five-year follow-up study. J Clin Gastroenterol. 2009;43:534–40.CrossRefPubMed Jung IS, Kim HS, Park H, Lee SI. The clinical course of post irritable bowel syndrome: a five-year follow-up study. J Clin Gastroenterol. 2009;43:534–40.CrossRefPubMed
11.
Zurück zum Zitat Ji S, Park H, Lee D, Song YK, Choi JP, Lee SI. Post-infection irritable bowel syndrome in patients with Shigella infection. J Gastroenterol Hepatol. 2005;20:381–6.CrossRefPubMed Ji S, Park H, Lee D, Song YK, Choi JP, Lee SI. Post-infection irritable bowel syndrome in patients with Shigella infection. J Gastroenterol Hepatol. 2005;20:381–6.CrossRefPubMed
12.
Zurück zum Zitat Kim HS, Kim MS, Ji SW, Park H. The development of irritable bowel syndrome after Shigella infection: 3 year follow-up study. Korean J Gastroenterol. 2006;47:300–5.PubMed Kim HS, Kim MS, Ji SW, Park H. The development of irritable bowel syndrome after Shigella infection: 3 year follow-up study. Korean J Gastroenterol. 2006;47:300–5.PubMed
13.
14.
Zurück zum Zitat Rahman MM, Ghoshal UC, Sultana S, et al. Long-term gastrointestinal consequences are frequent following sporadic acute infectious diarrhea in a tropical country: a prospective cohort study. Am J Gastroenterol. 2018;113:1363–75.CrossRefPubMed Rahman MM, Ghoshal UC, Sultana S, et al. Long-term gastrointestinal consequences are frequent following sporadic acute infectious diarrhea in a tropical country: a prospective cohort study. Am J Gastroenterol. 2018;113:1363–75.CrossRefPubMed
15.
Zurück zum Zitat Gwee KA, Graham JC, Mckendrick MW, et al. Psychometric scores and persistence of irritable bowel after infectious diarrhoea. Lancet. 1996;347:150–3.CrossRefPubMed Gwee KA, Graham JC, Mckendrick MW, et al. Psychometric scores and persistence of irritable bowel after infectious diarrhoea. Lancet. 1996;347:150–3.CrossRefPubMed
17.
Zurück zum Zitat Neal KR, Hebden J, Spiller R. Prevalence of gastrointestinal symptoms six months after bacterial gastroenteritis and risk factors for development of the irritable bowel syndrome: postal survey of patients. Br Med J. 1997;314:779–82.CrossRef Neal KR, Hebden J, Spiller R. Prevalence of gastrointestinal symptoms six months after bacterial gastroenteritis and risk factors for development of the irritable bowel syndrome: postal survey of patients. Br Med J. 1997;314:779–82.CrossRef
18.
Zurück zum Zitat Rodríguez LA, Ruigómez A. Increased risk of irritable bowel syndrome after bacterial gastroenteritis: cohort study. Br Med J. 1999;318:565–6.CrossRef Rodríguez LA, Ruigómez A. Increased risk of irritable bowel syndrome after bacterial gastroenteritis: cohort study. Br Med J. 1999;318:565–6.CrossRef
19.
Zurück zum Zitat Carding S, Verbeke K, Vipond DT, Corfe BM, Owen LJ. Dysbiosis of the gut microbiota in disease. Microb Ecol Health Dis. 2015;26:26191.PubMed Carding S, Verbeke K, Vipond DT, Corfe BM, Owen LJ. Dysbiosis of the gut microbiota in disease. Microb Ecol Health Dis. 2015;26:26191.PubMed
20.
Zurück zum Zitat Thabane M, Kottachchi DT, Marshall JK. Systematic review and meta-analysis: the incidence and prognosis of post-infection irritable bowel syndrome. Aliment Pharmacol Ther. 2007;26:535–44.CrossRefPubMed Thabane M, Kottachchi DT, Marshall JK. Systematic review and meta-analysis: the incidence and prognosis of post-infection irritable bowel syndrome. Aliment Pharmacol Ther. 2007;26:535–44.CrossRefPubMed
21.
Zurück zum Zitat Hanevik K, Dizdar V, Langeland N, Hausken T. Development of functional gastrointestinal disorders after Giardia lamblia infection. BMC Gastroenterol. 2009;9:27.CrossRefPubMedPubMedCentral Hanevik K, Dizdar V, Langeland N, Hausken T. Development of functional gastrointestinal disorders after Giardia lamblia infection. BMC Gastroenterol. 2009;9:27.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Grazioli B, Matera G, Laratta C, et al. Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia: a prospective study. World J Gastroenterol. 2006;12:1941–4.CrossRefPubMedPubMedCentral Grazioli B, Matera G, Laratta C, et al. Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia: a prospective study. World J Gastroenterol. 2006;12:1941–4.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Paula H, Grover M, Halder SL, et al. Non-enteric infections, antibiotic use, and risk of development of functional gastrointestinal disorders. Neurogastroenterol Motil. 2015;27:1580–6.CrossRefPubMedPubMedCentral Paula H, Grover M, Halder SL, et al. Non-enteric infections, antibiotic use, and risk of development of functional gastrointestinal disorders. Neurogastroenterol Motil. 2015;27:1580–6.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Maxwell PR, Rink E, Kumar D, Mendall MA. Antibiotics increase functional abdominal symptoms. Am J Gastroenterol. 2002;97:104–8.CrossRefPubMed Maxwell PR, Rink E, Kumar D, Mendall MA. Antibiotics increase functional abdominal symptoms. Am J Gastroenterol. 2002;97:104–8.CrossRefPubMed
25.
Zurück zum Zitat Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2008;27:22–8.PubMed Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India: report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol. 2008;27:22–8.PubMed
26.
Zurück zum Zitat Masud MA, Hasan M, Khan AK. Irritable bowel syndrome in a rural community in Bangladesh: prevalence, symptoms pattern, and health care seeking behavior. Am J Gastroenterol. 2001;96:1547–52.CrossRefPubMed Masud MA, Hasan M, Khan AK. Irritable bowel syndrome in a rural community in Bangladesh: prevalence, symptoms pattern, and health care seeking behavior. Am J Gastroenterol. 2001;96:1547–52.CrossRefPubMed
27.
Zurück zum Zitat Husain N, Chaudhry IB, Jafri F, Niaz SK, Tomenson B, Creed F. A population-based study of irritable bowel syndrome in a non-Western population. Neurogastroenterol Motil. 2008;20:1022–9.CrossRefPubMed Husain N, Chaudhry IB, Jafri F, Niaz SK, Tomenson B, Creed F. A population-based study of irritable bowel syndrome in a non-Western population. Neurogastroenterol Motil. 2008;20:1022–9.CrossRefPubMed
28.
Zurück zum Zitat Gwee KA, Collins SM, Read NW, et al. Increased rectal mucosal expression of interleukin 1beta in recently acquired post-infection irritable bowel syndrome. Gut. 2003;52:523–6.CrossRefPubMedPubMedCentral Gwee KA, Collins SM, Read NW, et al. Increased rectal mucosal expression of interleukin 1beta in recently acquired post-infection irritable bowel syndrome. Gut. 2003;52:523–6.CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Mathan VI, Baker SJ. Epidemic tropical sprue and other epidemics of diarrhea in South Indian villages. Am J Clin Nutr. 1968;21:1077–87.CrossRefPubMed Mathan VI, Baker SJ. Epidemic tropical sprue and other epidemics of diarrhea in South Indian villages. Am J Clin Nutr. 1968;21:1077–87.CrossRefPubMed
30.
Zurück zum Zitat Montgomery RD, Shearer AC. The cell population of the upper jejunal mucosa in tropical sprue and postinfective malabsorption. Gut. 1974;15:387–91.CrossRefPubMedPubMedCentral Montgomery RD, Shearer AC. The cell population of the upper jejunal mucosa in tropical sprue and postinfective malabsorption. Gut. 1974;15:387–91.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Parry SD, Stansfield R, Jelley D, et al. Does bacterial gastroenteritis predispose people to functional gastrointestinal disorders? A prospective, community-based, case-control study. Am J Gastroenterol. 2003;98:1970–5.PubMed Parry SD, Stansfield R, Jelley D, et al. Does bacterial gastroenteritis predispose people to functional gastrointestinal disorders? A prospective, community-based, case-control study. Am J Gastroenterol. 2003;98:1970–5.PubMed
34.
Zurück zum Zitat Pan G, Lu S, Ke M, Han S, Guo H, Fang X. Epidemiologic study of the irritable bowel syndrome in Beijing: stratified randomized study by cluster sampling. Chin Med J. 2000;113:35–9.PubMed Pan G, Lu S, Ke M, Han S, Guo H, Fang X. Epidemiologic study of the irritable bowel syndrome in Beijing: stratified randomized study by cluster sampling. Chin Med J. 2000;113:35–9.PubMed
35.
Zurück zum Zitat Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis. Gut. 2007;56:1066–71.CrossRefPubMedPubMedCentral Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis. Gut. 2007;56:1066–71.CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Tuteja AK, Talley NJ, Gelman SS, et al. Development of functional diarrhea, constipation, irritable bowel syndrome, and dyspepsia during and after travelling outside the USA. Dig Dis Sci. 2008;53:271–6.CrossRefPubMed Tuteja AK, Talley NJ, Gelman SS, et al. Development of functional diarrhea, constipation, irritable bowel syndrome, and dyspepsia during and after travelling outside the USA. Dig Dis Sci. 2008;53:271–6.CrossRefPubMed
37.
38.
Zurück zum Zitat Sykes MA, Blanchard EB, Lackner J, Keefer L, Krasner S. Psychopathology in irritable bowel syndrome: support for a psychophysiological model. J Behav Med. 2003;26:361–72.CrossRefPubMed Sykes MA, Blanchard EB, Lackner J, Keefer L, Krasner S. Psychopathology in irritable bowel syndrome: support for a psychophysiological model. J Behav Med. 2003;26:361–72.CrossRefPubMed
39.
Zurück zum Zitat Ghoshal UC, Ghoshal U, Ayyagari A, et al. Tropical sprue is associated with contamination of small bowel with aerobic bacteria and reversible prolongation of orocecal transit time. J Gastroenterol Hepatol. 2003;18:540–7.CrossRefPubMed Ghoshal UC, Ghoshal U, Ayyagari A, et al. Tropical sprue is associated with contamination of small bowel with aerobic bacteria and reversible prolongation of orocecal transit time. J Gastroenterol Hepatol. 2003;18:540–7.CrossRefPubMed
40.
Zurück zum Zitat Spiller R, Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009;136:1979–88.CrossRefPubMed Spiller R, Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009;136:1979–88.CrossRefPubMed
41.
Zurück zum Zitat Ghoshal UC, Kumar S, Mehrotra M, Lakshmi C, Misra A. Frequency of small intestinal bacterial overgrowth in patients with irritable bowel syndrome and chronic non-specific diarrhea. J Neurogastroenterol Motil. 2010;16:40–6. Ghoshal UC, Kumar S, Mehrotra M, Lakshmi C, Misra A. Frequency of small intestinal bacterial overgrowth in patients with irritable bowel syndrome and chronic non-specific diarrhea. J Neurogastroenterol Motil. 2010;16:40–6.
42.
Zurück zum Zitat Malinen E, Rinttila T, Kajander K, et al. Analysis of the fecal microbiota of irritable bowel syndrome patients and healthy controls with real-time PCR. Am J Gastroenterol. 2005;100:373–82.CrossRefPubMed Malinen E, Rinttila T, Kajander K, et al. Analysis of the fecal microbiota of irritable bowel syndrome patients and healthy controls with real-time PCR. Am J Gastroenterol. 2005;100:373–82.CrossRefPubMed
43.
Zurück zum Zitat Ghoshal UC, Park H, Gwee KA. Bugs and irritable bowel syndrome: the good, the bad and the ugly. J Gastroenterol Hepatol. 2010;25:244–51.CrossRefPubMed Ghoshal UC, Park H, Gwee KA. Bugs and irritable bowel syndrome: the good, the bad and the ugly. J Gastroenterol Hepatol. 2010;25:244–51.CrossRefPubMed
Metadaten
Titel
A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India
verfasst von
Prasanta Kumar Parida
Debakanta Mishra
Girish Kumar Pati
Preetam Nath
Kaibalya Ranjan Dash
Sambit Kumar Behera
Suryakanta Parida
Chitta Ranjan Khatua
Subhendu Panigrahi
Amarendra Mahapatra
Hemant Kumar Khuntia
Shivaram Prasad Singh
Publikationsdatum
04.04.2019
Verlag
Springer India
Erschienen in
Indian Journal of Gastroenterology / Ausgabe 2/2019
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-019-00943-w

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