The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Distinctive Clinical, Psychological, and Histological Features of Postinfective Irritable Bowel Syndrome
Abstract
OBJECTIVE: Irritable bowel syndrome after gastroenteritis is well recognized. Our aim was to determine whether postinfective IBS (PI-IBS) has histological or clinical features that are distinct from those of IBS patients with no history of preceding infection. METHODS: A total of 75 consecutive IBS outpatients and 36 healthy control subjects completed a questionnaire detailing symptoms, mode of onset, and previous psychiatric history. All underwent a full diagnostic workup including rectal biopsy, which included immunostaining and quantification for lamina propria or intraepithelial T lymphocytes, serotonin-containing enterochromaffin (EC), and mast cells. Patients were divided according to onset of symptoms into PI-IBS (n = 23) or non-PI-IBS (n = 52) patients. RESULTS: Diarrhea predominance occurred more frequently in PI-IBS (70%) than in non-PI-IBS (42%) patients (p = 0.03). A history of previous treatment for anxiety or depression was present in 26% of PI-IBS patients compared to 54% of non-PI-IBS (p = 0.02). Biopsy results for all patients were normal using conventional criteria; however, quantification revealed that PI-IBS showed increased EC cells compared to those of non-PI-IBS patients (p = 0.017) and controls (p = 0.02). Lamina propria T lymphocytes were increased in PI-IBS (p = 0.026) and non-PI-IBS (p = 0.011) patients compared to controls. Mast cells were increased in non-PI-IBS patients (p = 0.054) compared to controls. CONCLUSIONS: Individuals with PI-IBS are a clinically distinct subgroup characterized by diarrheal symptoms, less psychiatric illness, and increased serotonin-containing EC cells compared to those with non-PI-IBS.
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In the citing paper
“Other investigators have reported increased gastrointestinal permeability and elevated immune cell counts, even in patients with IBS without an infective aetiology. 54,55”
From Irritable bowel syndrome (2020) · cites this paper as [55]
In the citing paper
“Additionally, increased concentrations of CD3+ T cells in the colon and rectum and in the myenteric plexus of the small intestine were increased in these patients compared with normal controls (36, 46, 57, 58, 89, 94, 133, 168, 174).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [58]
In the citing paper
“However, as with mast cells, IELs are not consistently elevated in IBS patients (57, 58, 133).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [58]
In the citing paper
“However, some studies failed to demonstrate increased activated mast cells in IBS patients (35, 36, 57, 58, 168) and there are no consistent differences in the tissue concentrations of activated mast cells in patients with different IBS subtypes (36, 189).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [58]
In the citing paper
“The importance of the interaction between the intestinal microbiota and immune system in IBS patients is demonstrated by a few studies in patients with PI-IBS, indicating activation of the GI immune system following the acute GI infection (57, 58, 75, 89, 94, 124, 168, 170, 187)”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [58]
In the citing paper
“The evidence from these in vitro studies may shed light on the reported association of stressful life events with the duration of gastroenteritis, and with the subsequent development of postinfectious IBS.37”
From Principles and clinical implications of the brain-gut-enteric microbiota axis (2009) · cites this paper as [37]
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“Eligible participants in the genetic study were divided nto 4 groups for analysis: (1) those who did not experince acute gastroenteritis during the outbreak and did ot develop IBS (n 398); (2) those who experienced cute gastroenteritis but did not develop IBS (n 581); 3) those with self-reported acute gastroenteritis…”
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“Proposed potential mechanisms that initiate this inflammatory response include infections (10), changes in intestinal flora, and undiagnosed food allergies (11), while environmental, genetic factors (12), or an altered cytokine response contribute to the persistence of inflammation.”
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“Others have reported an increased number of mast cells in the terminal ileum,(18) while the number of these cells was normal in the rectum.(18,19)”
Is Irritable Bowel Syndrome a Low-Grade Inflammatory Bowel Disease?
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“This is in accordance with another study in IBS patients with or without history of previous gastroenteritis where increased numbers of lamina propria lymphocytes and mast cells were found [39].”
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“previously asymptomatic individuals who developed new FD symptoms immediately following a bout of acute GI inflammation, and applied the same criteria to post-infectious IBS patients.(13) Post-infectious FD was defined as GI symptoms that develop directly after the”
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“The original description by Chaudhary and Truelove(2) suggested that PI-IBS had less psychiatric illness than IBS patients with no infectious precipitant,(2) a feature confirmed in a series of outpatients with IBS.(4)”
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“Accordingly, one of the most frequently reported phenomena in IBS patients is increased numbers of intraepithelial T lymphocytes and lamina propria T lymphocytes, which has been found in the colonic mucosa of both non-post-infectious IBS patients (”
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“In fact, mast cells are identified as a common factor linking stress, food allergies, and IBS,(43) because increased numbers of mast cells are present in IBS gut mucosa and a significant proportion of individuals with IBS report adverse reactions to foods.(44,45) Finally, probiotics have been shown to be beneficial in…”
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“The number of EC cells in the rectal ucosa was normal in this study, but when looking specifially at patients with post-infectious IBS the number of EC ells has been upregulated [142,143] and the density of seroonin positively stained nerve fibers increased [144].”
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“None of the IBS patients had a history of PI-IBS, which has been defined as the new onset of IBS symptoms immediately following an acute illness characterized by vomiting, diarrhea, or a positive bacterial stool culture (”
BackgroundImmune Activation in Irritable Bowel Syndrome: Can Neuroimmune Interactions Explain Symptoms?
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“In intestinal mucosa, intraepithelial lymphocytes were found to be increased in the colon or jejunum of D-IBS patients (19, 42) and in the rectum of PI-IBS patients (98), but were unchanged in the rectum of both PI- and non PI-IBS patients (25) or duodenum of D-IBS patients (90).”
BackgroundGut inflammation in chronic fatigue syndrome
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“Furthermore, alterations in gut function are observed after the resolution of an acute intestinal inflammation [23,24].”
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“There is some evidence that IBS patients who report that their illness was triggered by an initial infective episode have fewer psychiatric symptoms than patients who do not (27).”
BackgroundInfection, inflammation, and the irritable bowel syndrome
Spiller, R., & Garsed, K. (2009) · Digestive and Liver Disease · doi:10.1016/j.dld.2009.07.007 · Cited by 122
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“…changes have also been described in the mucosa following T. spiralis infection, including EC cell hyperplasia and decreased immunostaining for SERT (Wheatcroft et al. 2005), which reflects an altered 5-HT bioavailability similar to that seen in PI-IBS patients (Dunlop et al. 2003a,b, 2005).”
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Metadata
- Authors
- Dunlop, S. P., Jenkins, D., & Spiller, R. C.
- Affiliations
- Nottingham University Hospitals NHS Trust (GB)
- ORCID
- Jenkins, David
- Venue
- American Journal of Gastroenterology
- Published
- 2003-07
- Volume
- 98
- Issue
- 7
- Pages
- 1578-1583
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W2033889517
- Cited by
- 359
- References
- 32
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 5 · 2020: 10 · 2019: 9 · 2018: 14 · 2017: 13 · 2016: 17 · 2015: 14 · 2014: 28 · 2013: 24 · 2012: 23
- FWCI
- 12.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Microscopic Colitis
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Keywords
- irritable bowel syndrome, gastroenteritis, rectal biopsy, enterochromaffin cells, serotonin, mast cells, diarrhea, psychiatric comorbidity, anxiety, depression, immunohistochemistry
- MeSH terms
- Adult, Mental Disorders, Biopsy, Cell Count, Colonic Diseases, Functional, Diarrhea, Enterochromaffin Cells, Female, Gastroenteritis, Humans, Immunohistochemistry, Male, Mast Cells, Middle Aged, Rectum, Serotonin, T-Lymphocytes
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