Postinfectious irritable bowel syndrome: a long-term consequence of bacterial gastroenteritis

Irritable bowel syndrome (IBS) is a commonly diagnosed disease characterized by gastrointestinal symptoms that may be associated with psychological illness and emotional problems. The prevalence rate worldwide for IBS ranges from 10 to 20% and is higher for women than for men. IBS imposes a substantial financial burden on both patients and employers because of increased medical costs and decreased work productivity. Recent studies indicate that inflammatory processes involving the gastrointestinal tract are strongly correlated with IBS. Acute bacterial gastroenteritis has been linked with the onset of symptoms in approximately 15% of patients diagnosed with IBS; these cases have been called postinfectious IBS. Organisms commonly associated with postinfectious IBS include the foodborne pathogens Campylobacter, Escherichia coli, Salmonella, and Shigella. The pathologic changes associated with postinfectious IBS are likely due to inflammatory reactions induced by the infecting organisms. Postinfectious IBS should be recognized as a potential long-term consequence of foodborne gastroenteritis.