Parry, S.D.; Barton, J.R.; Welfare, M.R.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA84
Academic Journal
Introduction: Irritable bowel syndrome (lBS) can be triggered by psychological stress, alterations in gut motor function and/or visceral perception. Previous studies suggest 4-32% of people develop lBS after bacterial gastroenteritis but the exact mechanisms underlying post-infectious lBS are not clear. Aim: To look into the role of possible causative factors in the development of post-infectious functional gastrointestinal disorders, namely lBS, functional dyspepsia, or functional diarrhoea. Methods: A prospective cohort study. There were 128 subjects without a prior FGID under study and with recent stool positive bacterial gastroenteritis who consented to participate. The presence or not of lBS, functional dyspepsia or functional diarrhoea was diagnosed at the start and on follow up at 6 months using self-complete Rome II modular questionnaires. Data on demographics, social class, infecting organism, smoking and alcohol use, anxiety, depression (via Hospital Anxiety and Depression Scale) and life events and impact (via LiFe Events Survey) were collected at the start of the study. Results: One hundred and seven Rome II questionnaires were returned at follow up. Twenty-five subjects developed a FGID, 16 who had symptoms consistent with lBS. Of the factors mentioned, only smoking was significantly associated with the development of a postinfectious FGID (odds ratio 4.1; CI 1.4 to 11.6). The odds ratio of a smoker developing post-infectious lBS was 3.6 (CI 1.12 to 11.60). The odds ratios of a smoker developing functional diarrhoea or functional dyspepsia were not statistically significant. Conclusion: Post-infectious lBS appears to be associated with smoking and we did not find evidence of association with life events, anxiety, or depression. Smoking is known to moderate gut immunity in other disorders such as ulcerative colitis and Crohn's disease. Our study adds to increasing evidence for an organic basis to post-infectious lBS, perhaps moderated via...


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