Systematic review and meta-analysis: The incidence and prognosis of post-infectious irritable bowel syndrome – Source: Alimentary Pharmacology & Therapeutics, Aug 2007

Background: Individual studies suggest that post-infectious irritable bowel syndrome is common, but symptoms gradually improve.

Aim: To review evidence for an association between intestinal infection and development of irritable bowel syndrome, assess the prognosis of post-infectious irritable bowel syndrome and explore factors that increase the risk.

Methods: MEDLINE (1966–2007) and EMBASE (1980–2007) databases were searched to identify the studies of post-infectious irritable bowel syndrome epidemiology. Data were extracted by two independent reviewers. Pooled odds ratios (POR) and corresponding 95% CI for incidence of irritable bowel syndrome were estimated among the exposed and unexposed groups.

Results: Eighteen of 26 studies identified were eligible for inclusion. Intestinal infection was associated with increased odds of developing irritable bowel syndrome at study end (POR = 5.86; 95% CI: 3.60–9.54). In subgroup analysis, the odds of developing irritable bowel syndrome was increased at 3 months (POR = 7.58; 95% CI: 4.27–13.45), 6 months (POR = 5.18; 95% CI: 3.24–8.26), 12 months (POR = 6.37; 95% CI: 2.63–15.40) and 24–36 months (POR = 3.85; 95% CI: 2.95–5.02). Among all studies (controlled and uncontrolled), the pooled incidence of irritable bowel syndrome at study conclusion was 10% (95% CI: 9.4–85.6). Subjects with post-infectious irritable bowel syndrome were younger and more anxious and depressed than those without post-infectious irritable bowel syndrome.

Conclusion: The odds of developing irritable bowel syndrome are increased six-fold after acute gastrointestinal infection. Young age, prolonged fever, anxiety and depression are risk factors for post-infectious irritable bowel syndrome.

Source: Alimentary Pharmacology & Therapeutics, August 2007. vol 26 #4 pp. 535-544. doi:10.1111/j.1365-2036.2007.03399.x by M. THABANE M, Kottachchi DT, Marshall, JK. Division of Gastroenterology, Department of Medicine; Intestinal Diseases Research Program, McMaster University, Hamilton, Ontario, Canada. [E-mail: Dr. J. K. Marshall, marshllj@mcmaster.ca ]

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