A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India.
Acute gastroenteritis
E. coli
Irritable bowel syndrome
Post-infection irritable bowel syndrome
Journal
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology
ISSN: 0975-0711
Titre abrégé: Indian J Gastroenterol
Pays: India
ID NLM: 8409436
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
30
08
2018
accepted:
24
01
2019
pubmed:
6
4
2019
medline:
28
1
2020
entrez:
6
4
2019
Statut:
ppublish
Résumé
Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score. This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested. Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively. One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.
Sections du résumé
BACKGROUND AND AIM
Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score.
METHODS
This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested.
RESULTS
Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively.
CONCLUSION
One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.
Identifiants
pubmed: 30949908
doi: 10.1007/s12664-019-00943-w
pii: 10.1007/s12664-019-00943-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
134-142Références
Indian J Gastroenterol. 2008 Jan-Feb;27(1):22-8
pubmed: 18541934
J Clin Gastroenterol. 2009 Jul;43(6):534-40
pubmed: 19262407
Am J Clin Nutr. 1968 Sep;21(9):1077-87
pubmed: 5675846
Lancet Infect Dis. 2017 Sep;17(9):909-948
pubmed: 28579426
Gut. 2017 Jun;66(6):1075-1082
pubmed: 26818616
Gut. 1999 Mar;44(3):400-6
pubmed: 10026328
Am J Gastroenterol. 2001 May;96(5):1547-52
pubmed: 11374697
Am J Gastroenterol. 2003 Jul;98(7):1578-83
pubmed: 12873581
Clin Gastroenterol Hepatol. 2007 Apr;5(4):457-60
pubmed: 17289440
Am J Gastroenterol. 2009 Sep;104(9):2267-74
pubmed: 19568228
J Neurogastroenterol Motil. 2010 Jan;16(1):40-6
pubmed: 20535325
Korean J Gastroenterol. 2006 Apr;47(4):300-5
pubmed: 16632982
Aliment Pharmacol Ther. 2007 Aug 15;26(4):535-44
pubmed: 17661757
BMJ. 1997 Mar 15;314(7083):779-82
pubmed: 9080994
J Behav Med. 2003 Aug;26(4):361-72
pubmed: 12921009
J Gastroenterol Hepatol. 2005 Mar;20(3):381-6
pubmed: 15740480
Dig Dis Sci. 2008 Jan;53(1):271-6
pubmed: 17549631
Neurogastroenterol Motil. 2008 Sep;20(9):1022-9
pubmed: 18492027
Gut. 2003 Apr;52(4):523-6
pubmed: 12631663
Postgrad Med J. 2006 Dec;82(974):779-87
pubmed: 17148698
BMJ. 1999 Feb 27;318(7183):565-6
pubmed: 10037630
Gut. 2007 Aug;56(8):1066-71
pubmed: 17324974
Q J Med. 1962 Jul;31:307-22
pubmed: 13878459
Am J Gastroenterol. 2018 Sep;113(9):1363-1375
pubmed: 30171215
Gut. 1974 May;15(5):387-91
pubmed: 18668848
Am J Gastroenterol. 2003 Sep;98(9):1970-5
pubmed: 14499773
BMC Gastroenterol. 2009 Apr 21;9:27
pubmed: 19383162
Neurogastroenterol Motil. 2015 Nov;27(11):1580-6
pubmed: 26303310
World J Gastroenterol. 2006 Mar 28;12(12):1941-4
pubmed: 16610003
J Gastroenterol Hepatol. 2009 Oct;24(10):1601-7
pubmed: 19788601
Br Med J. 1965 Aug 7;2(5457):326-9
pubmed: 14314449
J Gastroenterol Hepatol. 2003 May;18(5):540-7
pubmed: 12702046
Chin Med J (Engl). 2000 Jan;113(1):35-9
pubmed: 11775207
J Gastroenterol Hepatol. 2010 Feb;25(2):244-51
pubmed: 20074148
Gut. 2004 Aug;53(8):1096-101
pubmed: 15247174
Br Med J. 1950 Feb 18;1(4650):405-9
pubmed: 15410136
World J Gastroenterol. 2017 Oct 7;23(37):6788-6801
pubmed: 29085223
Am J Gastroenterol. 2005 Feb;100(2):373-82
pubmed: 15667495
Lancet. 1996 Jan 20;347(8995):150-3
pubmed: 8544549
Gastroenterology. 2006 Apr;130(5):1377-90
pubmed: 16678553
Microb Ecol Health Dis. 2015 Feb 02;26:26191
pubmed: 25651997
Gastroenterology. 2009 May;136(6):1979-88
pubmed: 19457422
Am J Gastroenterol. 2002 Jan;97(1):104-8
pubmed: 11808932