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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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]
Citations
Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
Functional bowel disorders and functional abdominal pain
Thompson, W. G., Longstreth, G. F., Drossman, D. A., Heaton, K. W., Irvine, E. J., & Müller-Lissner, S. A. (1999) · Gut · doi:10.1136/gut.45.2008.ii43 · Cited by 2,440
Spiller, R. C., Jenkins, D., Thornley, J. P., Hebden, J. M., Wright, T., Skinner, M., & Neal, K. R. (2000) · Gut · doi:10.1136/gut.47.6.804 · Cited by 1,155
Self-citationActivation of the mucosal immune system in irritable bowel syndrome
Chadwick, V. S., Chen, W., Shu, D., Paulus, B., Bethwaite, P., Tie, A., & Wilson, I. (2002) · Gastroenterology · doi:10.1053/gast.2002.33579 · Cited by 833
The role of psychological and biological factors in postinfective gut dysfunction
Gwee, K.-A., Leong, Y.-L., Graham, C., McKendrick, M. W., Collins, S. M., Walters, S. J., Underwood, J. E., & Read, N. W. (1999) · Gut · doi:10.1136/gut.44.3.400 · Cited by 764
Neal, K. R., Hebden, J., & Spiller, R. (1997) · BMJ · doi:10.1136/bmj.314.7083.779 · Cited by 586
Self-citationIncreased mast cells in the irritable bowel syndrome
O’Sullivan, Clayton, Breslin, Harman, Bountra, Mclaren, & O’Morain (2000) · Neurogastroenterology & Motility · doi:10.1046/j.1365-2982.2000.00221.x · Cited by 480
Psychometric scores and persistence of irritable bowel after infectious diarrhoea
Gwee, K., Read, N. W., Graham, J. C., McKendrick, M. W., Collins, S. M., Marshall, J. S., & Walters, S. J. (1996) · The Lancet · doi:10.1016/s0140-6736(96)90341-4 · Cited by 466
Role of Serotonin in the Immune System and in Neuroimmune Interactions
Mößner, R., & Lesch, K. (1998) · Brain Behavior and Immunity · doi:10.1006/brbi.1998.0532 · Cited by 434
Psychometric scores and persistence of irritable bowel after infectious diarrhoea
Ka, G., Graham, J. C., McKendrick, M. W., Collins, S. M., Marshall, J. S., Walters, S., & Read, N. W. (1996) · African journal of medical practice · Cited by 429
Research works printed but not linked: 5
- Thompson WG, 1999, Gut, 45, II43
- 10.1016/S0002-9270(98)00751-5 · DOI
- Plaisancie P, 1998, Am J Physiol, 275, G1073
- Frieling T, 1994, Am J Physiol, 266, G132
- Salzmann JL, 1989, Lab Invest, 60, 847
Cited by
Sorted by citations
Items 301–359 of 359
Novel therapeutic approaches in the treatment of irritable bowel syndrome
Pregun, I., Herszényi, L., Juhász, M. F., Miheller, P., & Tulassay, Z. (2007) · Orvosi Hetilap · doi:10.1556/oh.2007.27995 · Cited by 2
A 54-Year-Old Woman With Constipation-Predominant Irritable Bowel Syndrome
Lembo, A. J. (2006) · JAMA · doi:10.1001/jama.295.8.925 · Cited by 2
Genetics, Mucosal Inflammation and the Environment in Post-Infectious Chronic Gut Syndromes
Walker, M. M., Keely, S., Scott, R. J., & Talley, N. J. (2016) · The American Journal of Gastroenterology Supplements · doi:10.1038/ajgsup.2016.14 · Cited by 2
Post-infectious irritable bowel syndrome
Plotnikova, E. Y. (2018) · Herald of Pancreatic Club · doi:10.33149/vkp.2018.02.09 · Cited by 2
Emerging therapies in the management of Irritable Bowel Syndrome (IBS)
Elwing, J. E., Atassi, H., Rogers, B. D., & Sayuk, G. S. (2022) · Expert Opinion on Emerging Drugs · doi:10.1080/14728214.2022.2052043 · Cited by 2
“Several relevant mechanistic precursors to the development of IBS have been identified, including genetic factors [57] and environmental exposures, including infections [58], childhood trauma [59], and chronic life stressors [60].”
BackgroundIrritable Bowel Syndrome in Inflammatory Bowel Disease
Ryu, K.-H., & Huh, K. (2010) · Intestinal Research · doi:10.5217/ir.2010.8.2.95 · Cited by 2
Practical Evaluation and Handling of Patients with Irritable Bowel Syndrome
Ohlsson, B. (2013) · EMJ Gastroenterology · doi:10.33590/emjgastroenterol/10313126 · Cited by 2
Diarrhea‐Predominant Bowel Disorders Following Inflammation and Infection
Spiller, R. E. (2004) · doi:10.1002/9780470760307.ch15 · Cited by 2
Self-citationIrritable bowel syndrome in the general population : epidemiology, comorbidity and societal costs
Hillilä, M. T. (2010) · Työväentutkimus Vuosikirja · Cited by 2
New approach to chronic recurrent abdominal pain in children
Yang, H. R. (2006) · Korean Journal of Pediatrics · doi:10.3345/kjp.2006.49.2.129 · Cited by 2
Simmering Innards: Does Irritable Bowl Syndrome Have an Immunological Basis?
Andrews, C. N., & Shaffer, E. A. (2004) · Canadian Journal of Gastroenterology · doi:10.1155/2004/707528 · Cited by 2
“Elevated mucosal T lymphocytes (determined by CD3+ staining) were identified in both PI-IBS patients and IBS patients without a discrete time of onset of symptoms (24,26,31).”
BackgroundXu, X., Huang, Y., Ma, Z., & Liu, Z. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s513906 · Cited by 1
Immune biomarkers in irritable bowel syndrome: a review
Kokkotou, E. G., & Gras-Miralles, B. (2013) · Current Biomarker Findings · doi:10.2147/cbf.s29207 · Cited by 1
“Finally, in the Walk-erton Health Study for clinical and genetic predictors of developing IBS within 2–3 years following an episode of acute gastroenteritis, Villani et al 76 identified the rs5743936:T variant of TLR9 (the receptor which mediates the recognition of bacterial unmethylated CpG dinucleotides) as an indep…”
InfluentialJoly, F., Coffin, B., & Messing, B. (2007) · Nutrition Clinique et Métabolisme · doi:10.1016/j.nupar.2007.04.004 · Cited by 1
Ramos, L., Vicario, M., & Santos, J. (2007) · Medicina Clínica · doi:10.1157/13106939 · Cited by 1
Alterations in the intestinal microbiota of subjects diagnosed with irritable bowel syndrome
Kassinen, A. (2009) · Cited by 1
Functional Gastrointestinal Disorders
Saps, M., & Dhroove, G. (2009) · Univalle Digital Repository (University of Valle) · Cited by 1
Quantitation of Colonic Cells as Severity Markers in Patients with Irritable Bowel Syndrome
Miri, M. B., Sadeghi, A., Moradi, A., Rostami‐Nejad, M., Ehsani-Ardekani, M.-J., Asadzadeh‐Aghdaei, H., Safari, M. T., & Zali, M. R. (2018) · Galen Medical Journal · doi:10.31661/gmj.v7i0.1063 · Cited by 1
The Intestinal Microbiota and Intestinal Disease: Irritable Bowel Syndrome
Keren, N., & Gophna, U. (2011) · Springer eBooks · doi:10.1007/978-3-642-21680-0_15 · Cited by 1
Kanazawa, M., Palsson, O. S., van Tilburg, M. A. L., Gangarosa, L. M., Fukudo, S., Drossman, D. A., & Whitehead, W. E. (2010) · Gastroenterology · doi:10.1016/s0016-5085(10)60415-5 · Cited by 1
Bucci, C., Santonicola, A., & Iovino, P. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-802189-7.00040-x · Cited by 1
Is Post Infection-Irritable Bowel Syndrome Less Frequent in Mexico?
Schmulson, M. J. (2019) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000000098 · Cited by 1
Contribution of Gender to Pathophysiology and Clinical Presentation of IBS
Ouyang, A., & Wrzos, H. F. (2006) · The American Journal of Gastroenterology · doi:10.14309/00000434-200612001-00002 · Cited by 1
Peripheral and central factors in the pathophysiology of irritable bowel syndrome
Posserud, I. (2007) · Gothenburg University Publications Electronic Archive (Gothenburg University) · Cited by 1
Giardiasis in Bergen. Outbreak and clinical consequences.
Wensaas, K. (2011) · NORA - Norwegian Open Research Archives · Cited by 1
Immunité digestive et troubles fonctionnels intestinaux
Bueno, L. P. (2005) · Gastroentérologie Clinique et Biologique · doi:10.1016/s0399-8320(05)86354-7 · Cited by 1
Persistent Travelers' Diarrhea
Connor, B. A., & Shlim, D. R. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-1076-8.00021-1 · Cited by 1
Spence, M. (2005) · ResearchSpace (University of Auckland) · Cited by 1
Molecular mechanisms in the control of gastrointestinal function
Grundy, D., & Winchester, W. J. (2003) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2003.10.002
Róka, R. (2008) · SZTE Repository of Dissertations (University of Szeged)
Visceral hypersensitivity in Irritable Bowel Syndrome:pathophysiological mechanisms
Kerckhoffs, A. P. M. (2009) · Utrecht University Repository (Utrecht University)
Syndrome de l’intestin irritable (SII) : nouvelles pistes physiopathologiques
Bueno, L. P. (2007) · Côlon & Rectum · doi:10.1007/s11725-007-0061-9
“de biopsies coliques souligne des différences importantes avec une densité particulièrement élevée chez des SII-PI par rapport aux « non-postinfectieux » [22], cette densité plus élevée étant associée à un profil de patients psychologiquement plus affectés ou déprimés [23].”
Gut Inflammation in Irritable Bowel Syndrome
Gwee, K. (2013) · Wiley eBooks · doi:10.1002/9781118444689.ch9
Assessing the risk of irritable bowel syndrome one year post-acute gastroenteritis
Kowalcyk, B. B. (2011)
Post-infectious Irritable Bowel Syndrome in the Community: A Prospective Cohort Study
Ryu, H. S., & Choi, S. C. (2012) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2012.60.1.1
Reviewn in inflammatory bowel disease
Lakhan, S. E., & Kirchgessner, A. L. (2010)
Neural and neuro-immune mechanisms of visceral hypersensitivity in
Feng, B., Schwartz, E. S., & Gebhart, G. F. (2012)
Irritable bowel syndrome: current review on pathophysiology and diagnotic aspects.
Abdullah, M. (2008) · PubMed
Blanco, F., & Antoni, J. (2012) · TDX (Tesis Doctorals en Xarxa)
Sinagra, E., Rossi, F., Raimondo, D., Pietra, C., Pisciotto, P., Pompei, G., Tomasello, G., Cappello, F., Morreale, G. C., Amvrosiadis, G., et al. (2016)
Guilarte, M. (2014) · TDX (Tesis Doctorals en Xarxa)
Thijssen, A. Y. (2015) · Research Publications (Maastricht University) · doi:10.26481/dis.20151119at
David, L.-E., Blaga, T. S., Dumitrascu, D. L., & Haţieganu, I. (2015)
Persistent Gastrointestinal Symptoms in the Ill-Returning Traveler
Riddle, M. S., Shlim, D. R., & Connor, B. A. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-54696-6.00021-5
Infections Associated With Irritable Bowel Syndrome
Gurunathan, S. V., & Grover, M. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-54843-4.00007-6
Rees, J. R. (2014) · ASM Press eBooks · doi:10.1128/9781555815486.ch4
Gabbiani, G. (2006) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.1030324.357558
State-of-the Art Lecture: Irritable bowel syndrome: the new inflammatory bowel disease?
Spiller, R. E. (2007) · Springer eBooks · doi:10.1007/978-1-4020-5702-1_31
Self-citationPost-infectious irritable bowel syndrome: role of inflammation and gut flora
Spiller, R. E. (2007) · Springer eBooks · doi:10.1007/1-4020-4144-6_13
Self-citationLee, L., & Mullin, G. E. (2007) · CRC Press eBooks · doi:10.1201/9781420043013.ch13
Ait-Belgnaoui, A. (2006) · OpenGrey (Institut de l'Information Scientifique et Technique)
Quantitation of Colonic Cells as Severity Markers in Patients with Irritable Bowel Syndrome
Rostami‐Nejad, M., Miri, M. B., Sadeghi, A., Moradi, A., Ehsani-Ardekani, M.-J., Asadzadeh‐Aghdaei, H., Safari, M. T., & Zali, M. R. (2018) · Galen Medical Journal · doi:10.31661/gmj.v7i.1063
Duan, S., Kanda, H., Zhu, F., Okubo, M., Koike, T., Ohno, Y., Tanaka, T., Harima, Y., Miyamichi, K., Fukui, H., et al. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.07.22.604223
Mucosal Inflammation and Visceral Hypersensitivity in Irritable Bowel Syndrome
Komori, K., Ihara, E., & Akiho, H. (2024) · Springer eBooks · doi:10.1007/978-981-97-8410-3_6
Chaphekar, P. A., & Sharma, D. K. (2025) · Indian Journal of Research in Homoeopathy · doi:10.53945/2320-7094.1951
Bacon, R. L., Lawhon, S. D., Gray, S. B., & Hodo, C. L. (2026) · Frontiers in Veterinary Science · doi:10.3389/fvets.2026.1759338
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
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 ›
Are you an author, or do you see a problem with this page? Request a review