Post‐infectious IBS: Defining its clinical features and prognosis using an internet‐based survey
Open accessAbstract
Background: Gastrointestinal infection is an important risk factor for developing irritable bowel syndrome (IBS). Our aim was to characterise post‐infectious IBS (PI‐IBS) compared to other IBS patients. Methods: An internet survey of IBS patients using Rome III diagnostic questionnaire, Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire‐12 Somatic Symptom (PHQ12‐SS) scale score documenting the mode of onset was conducted. Results: A total of 7811 participants (63.2% female), of whom 1004 (13.3%) met criteria for PI‐IBS, were studied. Seventy per cent of PI‐IBS patients described sudden onset, 35% onset while travelling, 49.6% vomiting, 49.9% fever and 20.3% bloody diarrhoea. Compared to other IBS individuals, PI‐IBS was significantly associated with living in Northern Europe and North America, having a hysterectomy, not having an appendicectomy, higher PHQ12‐SS score and having more than one toilet in the family home. PI‐IBS patients had more frequent stools. At one year recovery rate in the PI‐IBS and non‐PI‐IBS group was 19.7% and 22.2%, p = 0.15. Recovery rates were lower for females (20.7%) vs males (38.8%), those with somatisation (23.0%) vs those without (33.2%) and those living in North America or Northern Europe (21.1%) vs living elsewhere (33.9%) p ≤ 0.001. Conclusion: PI‐IBS accounts for around 13% of all IBS in this internet sample, with some distinctive features but a similar prognosis to the remainder.
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Approximately 10% of people with IBS report that their symptoms commenced after an acute enteric infection.
“The fact that approximately 10% of people with IBS report that their symptoms commenced after an acute enteric infection, 13 known as postinfection IBS, has led to the concept that alterations in the gut microbiome may be involved in its pathophysiology.”
From Efficacy of Probiotics in Irritable Bowel Syndrome: Systematic Review and Meta-analysis (2023) · cites this paper as [13]
Previous acute enteric infection is present in approximately 10% of people with IBS.
“including previous acute enteric infection, present in approximately 10% of people with IBS, 112”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [112]
The best-recognised risk factor for IBS, observed in approximately 10% of patients, is prior acute enteric infection.
“Perhaps the best-recognised risk factor for IBS, observed in approximately 10% of patients, 17 is prior acute enteric infection.”
From Irritable bowel syndrome (2020) · cites this paper as [17]
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- Authors
- Card, T., Enck, P., Barbara, G., Boeckxstaens, G. E., Santos, J., Azpiroz, F., Mearin, F., Aziz, Q., Marshall, J., & Spiller, R.
- Affiliations
- Nottingham University Hospitals NHS Trust (GB)
- Universitätsklinikum Tübingen (DE)
- University of Bologna (IT)
- Universitair Ziekenhuis Leuven (BE)
- Digestive System Research Unit University Hospital Vall d’Hebron Bellaterra Spain
- Institute of Functional and Motor Disorders Centro Médico Teknon Barcelona Spain
- Queen Mary University of London (GB)
- McMaster University (CA)
- Nottingham Digestive Diseases Centre University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust and University of Nottingham Nottingham UK
- ORCID
- Venue
- United European Gastroenterology Journal
- Publisher
- Wiley
- Published
- 2018-10
- Volume
- 6
- Issue
- 8
- Pages
- 1245-1253
- ISSN
- 2050-6406 (ISSN-L)
- 2050-6414
- PMC
- PMC6169057
- OpenAlex
- W2800399579
- Cited by
- 59
- References
- 25
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 6 · 2023: 6 · 2022: 14 · 2021: 10 · 2020: 5 · 2019: 6 · 2018: 1
- FWCI
- 5.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- United European Gastroenterology Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion, other-oa)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Funders
- UEGW (UEGW 2009 working party grant)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Health Sciences › Medicine › Epidemiology › Microscopic Colitis
- Keywords
- post-infectious irritable bowel syndrome, irritable bowel syndrome, gastrointestinal infections, somatic symptoms, anxiety and depression, hysterectomy, appendectomy, mode of onset, Rome III criteria
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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