Postinfectious Irritable Bowel Syndrome

Postinfectious irritable bowel syndrome (PI-IBS) should be considered in patients who present with a change in bowel habits or an onset of new abdominal pain or discomfort following a recent confirmed or presumed exposure to infectious organisms, or in those who have recently returned from a tropical or developing country. In patients who are greatly distressed by their symptoms, an extended workup early in the course of their illness may give physician and patient confidence in focusing on IBS. The author favors a proactive, multicomponent approach to management, as it gives the physician and patient a sense of control. Treatment should include stress management, dietary advice to minimize exposure to trigger foods, and pharmacotherapy to alleviate anxiety and target disturbed physiology.