Postinfectious irritable bowel syndrome after travelers' diarrhea – a cohort study

Schwille‐Kiuntke, Juliane; Enck, Paul; Polster, Annikka; Gaile, Marika; Kremsner, Peter G.; Zanger, Philipp

doi:10.1111/nmo.12601

Cited by 10 publications

(9 citation statements)

References 49 publications

(100 reference statements)

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“…We found IBS‐affected individuals having not only higher scores for depression at the time of SHIP assessment, but also a more frequent history of a recurrent depressive episode in the past. This is in line with several other studies . This association raises the question, whether IBS is the cause or consequence of depression .…”

Section: Discussionsupporting

confidence: 93%

“…They further postulated at least two subgroups within the IBS-affected cohort with a mainly mental vs a mainly physical etiology of symptoms. Also, the interaction of both, mental and physical factors, is reported in the literature, 51 whereas a high number of comorbidities are suspected to be related to a more psychological IBS etiology. 20 We found IBS-affected individuals having not only higher scores for depression at the time of SHIP assessment, but also a more frequent history of a recurrent depressive episode in the past.…”

Section: Discussionmentioning

confidence: 99%

“…This is in line with several other studies. 22,51 This association raises the question, whether IBS is the cause or consequence of depression. 52 There is much evidence that psychological difficulties may worsen illness-no matter which type of illness and independent of the pathophysiology-and this effect may be explained by behavioral factors such as non-compliance or non-adherence.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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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“…Therefore, we included 45 studies (n=21,421 participants with IE exposure) that reported the prevalence of PI-IBS. 4, 5, 7–13, 15–17, 20, 23, 29– 59 The flow diagram summarizing study identification and selection is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis

et al. 2017

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Background & Aims Foodborne illness affects 15% of the United States population each year and is a risk factor for irritable bowel syndrome (IBS). We evaluated risk of, risk factors for, and outcomes of IBS after infectious enteritis Methods We performed a systematic review of electronic databases from 1994 through August 31, 2015 to identify cohort studies of the prevalence of IBS 3 months or more after infectious enteritis. We used random effects meta-analysis to calculate the summary point prevalence of IBS after infectious enteritis, as well as relative risk (compared to individuals without infectious enteritis) and host- and enteritis-related risk factors. Results We identified 45 studies, comprising 21,421 individuals with enteritis, followed for 3 months–10 years for development of IBS. The pooled prevalence of IBS at 12 months after infectious enteritis was 10.1% (95% CI, 7.2–14.1) and at more than 12 months after infectious enteritis was 14.5% (95% CI, 7.7–25.5). Risk of IBS was 4.2-fold higher in patients who had infectious enteritis in the past 12 months than in individuals in those who had not (95% CI, 3.1–5.7); risk of IBS was 2.3-fold higher in individuals who had infectious enteritis longer than 12 months ago than in individuals who had not (95% CI, 1.8–3.0). Of patients with enteritis caused by protozoa or parasites, 41.9% developed IBS; of patients with enteritis caused bacterial infection, 13.8% developed IBS. Risk of IBS was significantly increased in women (odds ratio [OR], 2.2; 95% CI, 1.6–3.1) and with antibiotic exposure (OR, 1.7; 95% CI, 1.2–2.4), anxiety (OR, 2; 95% CI, 1.3–2.9), depression (OR, 1.5; 95% CI, 1.2–1.9), somatization (OR, 4.1; 95% CI, 2.7–6.0), neuroticism (OR, 3.3; 95% CI, 1.6–6.5), and clinical indicators of enteritis severity. There was a considerable level of heterogeneity among studies. Conclusion In a systematic review and meta-analysis, we found more than 10% of patients with infectious enteritis to later develop IBS; risk of IBS was 4-fold higher than in individuals who did not have infectious enteritis, although there was heterogeneity among studies analyzed. Women—particularly those with severe enteritis—are at increased risk for developing IBS, as are individuals with psychological distress and users of antibiotics during the enteritis.

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“…Ähnliche Schlüs-se lassen prospektive Daten zum sog. postinfektiösen Reizdarmsyndrom (PI-RDS) zu, das durch akute Darminfektionen ausgelöst wird [24,26]. Chronische Stressbelastung und Depressivität erhö-hen dabei nachweislich das Risiko des PI-RDS.…”

Section: Affektstörungen Und Chronischer Stressunclassified

Psychobiologische Mechanismen bei der Pathophysiologie chronischer viszeraler Schmerzen

Elsenbruch

Enck

2016

Schmerz

Self Cite

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Although visceral pain is of high clinical relevance, it remains poorly understood especially when compared to somatic pain. Nevertheless, interdisciplinary research approaches bridging psychophysiology and neurogastroenterology have contributed to a more refined knowledge about the complex peripheral and central mechanisms of the bidirectional brain-gut axis in recent years. This review summarizes current knowledge regarding psychobiological mechanisms in the pathophysiology of chronic visceral pain in functional gastrointestinal disorders with a focus on irritable bowel syndrome (IBS). Special attention is paid to the role of affective disturbances and emotions, particularly psychological stress as well as to influences of cognition and learning on gastrointestinal motor and sensory functions in healthy individuals and patients with IBS. In this emerging field of research, new evidence from the fields of placebo research and pain-related fear conditioning provide new insights into the psychological and neurobiological mechanisms involved in the transition from acute to chronic pain and the maintenance of pain. This opens up new perspectives for innovative treatment approaches for IBS and other functional gastrointestinal disorders.

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Postinfectious irritable bowel syndrome after travelers' diarrhea – a cohort study

Abstract: Our findings underline the close linkage of mental and somatic processes for the manifestation of PI-IBS. Screening for psychiatric comorbidities in patients with severe gastrointestinal infections may allow identifying groups at high risk for PI-IBS.

Cited by 10 publications

References 49 publications

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

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

Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis

Psychobiologische Mechanismen bei der Pathophysiologie chronischer viszeraler Schmerzen

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