Incidence of irritable bowel syndrome and chronic fatigue following GI infection: a population-level study using routinely collected claims data

Donnachie, Ewan; Schneider, Antonius; Mehring, M.; Enck, Paul

doi:10.1136/gutjnl-2017-313713

Cited by 58 publications

(55 citation statements)

References 56 publications

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“…For example asthma and IBS might share an inflammatory aetiology but there are conflicting results concerning the effect of concurrent oral steroids IBS. 25,27,32 In conclusion, this review has shown that, in addition to gastroenteritis, there is a consistent and reasonably strong statistical association between onset of IBS and a range of pre-existing medical disorders (gastrointestinal and other), prior anxiety, depression, stress, frequent healthcare use and other pain disorders. 29 Several studies have shown that the psychological and general medical risk factors are independent and their affects are additive.…”

Section: Breadth and Strength Of Risk Factorsmentioning

confidence: 73%

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Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies

Creed

2019

Aliment Pharmacol Ther

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Background:In the absence of prior gastrointestinal infection, the risk factors for irritable bowel syndrome (IBS) are not well established.Aim: To identify the incidence and risk factors for IBS in general population samples Methods: Narrative review of population-based studies. Electronic databases were searched using the keywords "incidence," "onset," "epidemiology," "population," "risk factors" with "irritable bowel syndrome" with subsequent hand searching. Inclusion criteria were: population-based, adults, prospective design (including retrospective case cohorts), clinical or research diagnosis of IBS and exclusion of individuals who had IBS prior to recruitment. Results:Of 1963 papers, 38 were included; all provided data on risk factors, 27 reported incidence. The median incidence of physician-diagnosed IBS in 19 general population cohorts was 38.5 per 10 000 person-years (interquartile range = 20-45.3).In 14 cohorts with specific medical disorders, median incidence was 92 per 10 000 person-years (IQR: 73.9-119). Apart from gastroenteritis, the most common risk factors were other medical disorders, female sex, age (both young and old), anxiety and depression, life events/stress, frequent healthcare use, pain and sleep disorders. The results were conflicting for alcohol consumption, smoking and BMI. Incidence rates were similar in different countries but risk factors differed.Conclusions: Incidence rates were generally lower than previous estimates reflecting physician-diagnosed IBS. The results highlight the importance of other medical and psychosocial problems in the onset of IBS in addition to prior gastrointestinal infections. Aetiological research could be enhanced by studying the underlying mechanisms relating to all of these risk factors.

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Section: Breadth and Strength Of Risk Factorsmentioning

confidence: 73%

“…[25][26][27][28] Similarly chronic liver disease and fibromyalgia were independent and together they doubled the hazard ratio for IBS. [25][26][27][28] Similarly chronic liver disease and fibromyalgia were independent and together they doubled the hazard ratio for IBS.…”

Section: Risk Factors For New Onset Ibsmentioning

confidence: 94%

Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies

Creed

2019

Aliment Pharmacol Ther

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“…Female predominance in prevalence during the first 60‐70 years of life and a dissolution of this gender difference in people aged >65 years suggest an influence of gonadal sex hormones on IBS . Previous gastrointestinal infection has been shown to enhance the risk of IBS later on, but also other and non‐intestinal diseases . It is unclear whether the so‐called postinfectious IBS has to be considered as an own entity or whether the infection should be regarded as one risk factor among others .…”

Section: Introductionmentioning

confidence: 99%

Irritable bowel syndrome, mental health, and quality of life: Data from a population‐based survey in Germany (SHIP‐Trend‐0)

Schauer

Grabe

Ittermann

et al. 2018

Neurogastroenterology Motil

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Background Irritable bowel syndrome (IBS) is associated with reduced quality of life and high healthcare costs. This study aimed to assess the prevalence and risk factors for IBS in a general adult population. Methods The Study of Health in Pomerania (SHIP) is a population‐based cohort study in northeastern Germany. SHIP‐Trend‐0 participants enrolled from 2008 to 2012 were grouped according to Rome III criteria (main criteria: abdominal discomfort or crampy or bloating pain for at least six months plus 2/3 additional criteria). Factors associated with IBS were assessed using survey‐weighted backward stepwise logistic regression. Key Results The final data set included 4194 records. IBS prevalence was 3.5% (3.0%‐4.2%). Unemployment (OR: 2.02, 1.26‐3.21), headaches (OR: 2.37, 1.59‐3.52), mental quality of life (OR: 0.95 per unit increase, 0.93‐0.97), and interactions between gender and physical quality of life (P = 0.004) and gender and alexithymia (P = 0.002) predicted IBS probability. The model resulted in a good discrimination (area under the curve = 75.4%) and model fit (F = 0.72, P = 0.69). History of depression (OR: 2.77, 1.94‐3.95), back pain (OR: 2.38, 1.69‐3.35), early trauma (OR: 1.03, 1.02‐1.04), and duration of inpatient treatment within the last twelve months (OR: 1.02, 1.01‐1.04) lost their significance in multivariable analysis. Conclusions & Inferences IBS prevalence was relatively low compared to other studies. Factors predicting IBS were of biological, psychological, and social nature. The association between IBS and pain in different areas of the body indicates a potential underlying complex somatic symptom disorder.

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“…The impulse for this paper and the hypothesis it promotes (biology first!) was provided by a recently published paper . It claimed that, of the 2.5 million Bavarian adults who had consulted a physician between 2005 and 2013, more than 500 000 cases of infectious enteritis were identified.…”

Section: A Pi‐ibs Cohort Studymentioning

confidence: 99%

The “Biology‐First” Hypothesis: Functional disorders may begin and end with biology—A scoping review

Enck¹,

Mazurak²

2018

Neurogastroenterology Motil

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While it is generally accepted that gastrointestinal infections can cause functional disturbances in the upper and lower gastrointestinal tract-known as postinfectious irritable bowel syndrome (PI-IBS) and functional dyspepsia (PI-FD)-it has still not been widely recognized that such an infection can also initiate functional non-intestinal diseases, and that non-intestinal infections can provoke both intestinal and non-intestinal functional disturbances. We conducted a scoping review of the respective literature and-on the basis of these data-hypothesize that medically unexplained functional symptoms and syndromes following an infection may have a biological (genetic, endocrine, microbiological) origin, and that psychological and social factors, which may contribute to the disease "phenotype," are secondary to this biological cause. If this holds true, then the search for psychological and social theories and factors to explain why one patient develops a chronic functional disorder while another does not is-at least for postinfectious states-misleading and detracts from exploring and identifying the true origins of these essentially biological disorders. The biopsychosocial model may, as the term implies, always begin with biology, also for functional (somatoform) disorders.

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Incidence of irritable bowel syndrome and chronic fatigue following GI infection: a population-level study using routinely collected claims data

Abstract: Psychological disorder and GI infections are distinct risk factors for IBS. The high incidence of non-specific GI infection suggests that postinfectious IBS is a common clinical occurrence in primary care. Chronic fatigue is a further significant sequela of GI infection.

Cited by 58 publications

References 56 publications

Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies

Review article: the incidence and risk factors for irritable bowel syndrome in population‐based studies

Irritable bowel syndrome, mental health, and quality of life: Data from a population‐based survey in Germany (SHIP‐Trend‐0)

The “Biology‐First” Hypothesis: Functional disorders may begin and end with biology—A scoping review

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