Infection, inflammation, and the irritable bowel syndrome
Open accessAbstract
Gastrointestinal infection is ubiquitous worldwide though the pattern of infection varies widely. Poor hygiene and lack of piped water is associated with a high incidence of childhood infection, both viral and bacterial. However in developed countries bacterial infection is commoner in young adults. Studies of bacterial infections in developed countries suggest 75% of adults fully recover, however around 25% have long lasting changes in bowel habit and a smaller number develop the irritable bowel syndrome (IBS). Whether the incidence is similar in developing countries is unknown. Post-infective IBS (PI-IBS) shares many features with unselected IBS but by having a defined onset allows better definition of risk factors. These are in order of importance: severity of initial illness, smoking, female gender and adverse psychological factors. Symptoms may last many years for reasons which are unclear. They are likely to include genetic factors controlling the immune response, alterations in serotonin signaling, low grade mucosal inflammation maintained by psychological stressors and alterations in gut microbiota. As yet there are no proven specific treatments, though 5HT(3) receptor antagonists, anti-inflammatory agents and probiotics are all logical treatments which should be examined in large well-designed randomised placebo controlled trials.
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Clinical studies show that up to 20% of IBS is preceded by an enteric infection, which produces a profound alteration of the host microbiota.
“Clinical studies show that up to 20% of IBS is preceded by an enteric infection, which produces a profound alteration of the host microbiota [52] .”
From Intestinal microbiota in health and disease: Role of bifidobacteria in gut homeostasis (2014) · cites this paper as [52]
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Sorted by citations
5-Hydroxytryptamine (serotonin) in the gastrointestinal tract
Gershon, M. D. (2013) · Current Opinion in Endocrinology, Diabetes & Obesity · doi:10.1097/med.0b013e32835bc703 · Cited by 617 · see citing works
Disease burden of foodborne pathogens in the Netherlands, 2009
Havelaar, A. H., Haagsma, J. A., Mangen, M.-J. J., Kemmeren, J. M., Verhoef, L. P. B., Vijgen, S. M. C., Wilson, M., Friesema, I. H. M., Kortbeek, L. M., van Duynhoven, Y. T. H. P., et al. (2012) · International Journal of Food Microbiology · doi:10.1016/j.ijfoodmicro.2012.03.029 · Cited by 380 · see citing works
Horvath, A., Dziechciarz, P., & Szajewska, H. (2011) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04665.x · Cited by 201 · see citing works
Recent developments in the pathophysiology of irritable bowel syndrome
El-Salhy, M. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i25.7621 · Cited by 111 · see citing works
Visceral hypersensitivity in endometriosis: a new target for treatment?
Issa, B., Onon, T. S., Agrawal, A., Shekhar, C., Morris, J., Hamdy, S., & Whorwell, P. J. (2012) · Gut · doi:10.1136/gutjnl-2011-300306 · Cited by 90 · see citing works
Dietary therapies for functional bowel symptoms: Recent advances, challenges, and future directions
Tuck, C. J., & Vanner, S. J. (2018) · Neurogastroenterology & Motility · doi:10.1111/nmo.13238 · Cited by 52 · see citing works
- Authors
- Spiller, R., & Garsed, K.
- Affiliations
- Nottingham University Hospitals NHS Trust (GB)
- NIHR Nottingham Digestive Diseases Biomedical Research Unit (GB)
- Corresponding author
- Spiller, R.
- ORCID
- Spiller, R.
- Venue
- Digestive and Liver Disease
- Publisher
- Elsevier BV
- Published
- 2009-12
- Volume
- 41
- Issue
- 12
- Pages
- 844-849
- ISSN
- 1590-8658 (ISSN-L)
- OpenAlex
- W2003617540
- Cited by
- 122
- References
- 93
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 7 · 2020: 2 · 2019: 5 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 9 · 2014: 15 · 2013: 12 · 2012: 10
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Digestive and Liver Disease (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Keywords
- irritable bowel syndrome, gastrointestinal infections, bacterial infection, viral infection, pediatric infection, altered bowel habits, mucosal inflammation, serotonin signaling, gut microbiota, psychological stress, smoking, female sex, immune response genetics, 5-HT3 receptor antagonists, probiotics, anti-inflammatory agents
- MeSH terms
- Age Factors, Developing Countries, Gastroenteritis, Humans, Inflammation, Life Style, Risk Factors, Sex Factors, Incidence, Developed Countries, Gastrointestinal Tract, Irritable Bowel Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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