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Systematic review and meta-analysis: the incidence and prognosis of post-infectious irritable bowel syndrome

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THABANE, M., KOTTACHCHI, D. T., MARSHALL, J. K.·2007·Alimentary Pharmacology & Therapeutics
DOI 10.1111/j.1365-2036.2007.03399.x
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Abstract

Summary: Background Individual studies suggest that post‐infectious irritable bowel syndrome is common, but symptoms gradually improve. Aim To review evidence for an association between intestinal infection and development of irritable bowel syndrome, assess the prognosis of post‐infectious irritable bowel syndrome and explore factors that increase the risk. Methods MEDLINE (1966–2007) and EMBASE (1980–2007) databases were searched to identify the studies of post‐infectious irritable bowel syndrome epidemiology. Data were extracted by two independent reviewers. Pooled odds ratios (POR) and corresponding 95% CI for incidence of irritable bowel syndrome were estimated among the exposed and unexposed groups. Results Eighteen of 26 studies identified were eligible for inclusion. Intestinal infection was associated with increased odds of developing irritable bowel syndrome at study end (POR = 5.86; 95% CI: 3.60–9.54). In subgroup analysis, the odds of developing irritable bowel syndrome was increased at 3 months (POR = 7.58; 95% CI: 4.27–13.45), 6 months (POR = 5.18; 95% CI: 3.24–8.26), 12 months (POR = 6.37; 95% CI: 2.63–15.40) and 24–36 months (POR = 3.85; 95% CI: 2.95–5.02). Among all studies (controlled and uncontrolled), the pooled incidence of irritable bowel syndrome at study conclusion was 10% (95% CI: 9.4–85.6). Subjects with post‐infectious irritable bowel syndrome were younger and more anxious and depressed than those without post‐infectious irritable bowel syndrome. Conclusion The odds of developing irritable bowel syndrome are increased sixfold after acute gastrointestinal infection. Young age, prolonged fever, anxiety and depression are risk factors for post‐infectious irritable bowel syndrome.

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  • Changes in the gut microbiota have been implicated in the pathogenesis of GI disorders such as IBS.

    “Given that changes in the gut microbiota have been implicated in the pathogenesis of GI disorders [such as irritable bowel syndrome (IBS)],5–8 there is growing interest in therapies that might influence these changes, such as probiotics.”

    From Systematic review: probiotics in the management of lower gastrointestinal symptoms in clinical practice - an evidence-based international guide (2013) · cites this paper as [6]

  • The strongest risk factors for post-infectious irritable bowel syndrome are bacterial toxicity, prolonged duration of diarrhoea, rectal bleeding and fever.

    “in which the strongest risk factors are bacterial toxicity,128 prolonged duration of diarrhoea,124 rectal bleeding129 and fever.125”

    From Intestinal microbiota in functional bowel disorders: a Rome foundation report (2013) · cites this paper as [125]

  • A recent meta-analysis pooling 18 studies indicated a relative increased risk of developing irritable bowel syndrome 1 year after bacterial gastroenteritis, mostly Shigella, Campylobacter and Salmonella, with RR=6.5 and CI 2.6-15.4, an effect still apparent at 36 months with RR=3.9 and CI 3.0-5.0.

    “A recent meta-analysis pooling 18 studies indicated a relative increased risk of developing IBS 1 year after bacterial gastroenteritis (mostly Shigella, Campylobacter and Salmonella), RR=6.5 CI (2.6–15.4), an effect still apparent at 36 months, RR=3.9 (3.0–5.0).125”

    From Intestinal microbiota in functional bowel disorders: a Rome foundation report (2013) · cites this paper as [125]

  • Postinfectious IBS occurs in approximately 10% of patients with acute gastroenteritis.

    “PI-IBS occurs in ∼10% of patients with acute gastroenteritis, and acute gastroenteritis increases the odds of developing IBS six- to sevenfold (76, 157, 172).”

    From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [172]

  • Acute gastroenteritis increases the odds of developing IBS six- to sevenfold.

    “PI-IBS occurs in ∼10% of patients with acute gastroenteritis, and acute gastroenteritis increases the odds of developing IBS six- to sevenfold (76, 157, 172).”

    From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [172]

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Research works printed but not linked: 5

  1. M. THABANE et al. ª 2007 The Authors, Aliment Pharmacol Ther 26, 535-544 Journal compilation ª 2007 Blackwell Publishing Ltd 13652036, 2007, 4, · DOI
  2. Thornley JP, Jenkins D, Neal K, et al. Relationship of Campylobacter toxige- nicity in vitro to the development of post-infectious irritable bowel syn- drome. J Infect Dis 2001; 184: 606-9.
  3. Chaudhary NA, Truelove SC. The irrit- able colon syndrome. Quart J Med 1962; 123: 307-22.
  4. Drossman DA, Thompson WG, Talley NJ, et al. Identification of sub-groups of SYSTEMATIC REVIEW: POST-INFECTIOUS IB S 543 ª 2007 The Authors, Aliment Pharmacol Ther 26, 535-544 Journal compilation ª 2007 Blackwell Publishing Ltd 13652036, 2007, 4, functional gastrointestinal disorders. Gastroenterol Int 1990; 3: 159-72. · DOI
  5. Neal KR, Barker L, Spiller RC. Prognosis in post-infective irritable bowel syn- drome: a six year follow up study. Gut 2002; 51: 10-3.

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Authors
THABANE, M., KOTTACHCHI, D. T., & MARSHALL, J. K.
Affiliations
McMaster University (CA)
Corresponding author
MARSHALL, J. K.
ORCID
MARSHALL, J. K.
Venue
Alimentary Pharmacology & Therapeutics
Publisher
Wiley
Published
2007-06-07
Volume
26
Issue
4
Pages
535-544
ISSN
  • 0269-2813 (ISSN-L)
  • 1365-2036
DOI
10.1111/j.1365-2036.2007.03399.x
OpenAlex
W1483462250
Cited by
466
References
55
Citations by year
2026: 12 · 2025: 14 · 2024: 13 · 2023: 11 · 2022: 16 · 2021: 14 · 2020: 19 · 2019: 20 · 2018: 35 · 2017: 26 · 2016: 41 · 2015: 41 · 2014: 41 · 2013: 34 · 2012: 45
FWCI
3.33
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Alimentary Pharmacology & Therapeutics (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
  • Health Sciences › Health Professions › Pharmacy › Infant Health and Development
Keywords
post-infectious irritable bowel syndrome, intestinal infection, acute gastrointestinal infection, incidence, prognosis, risk factors, anxiety, depression, age, fever duration
MeSH terms
Bacterial Infections, Female, Gastroenteritis, Humans, Male, Risk Factors, Odds Ratio, Irritable Bowel Syndrome

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