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Arthritis risk after acute bacterial gastroenteritis
A X Garg1, J E Pope, H Thiessen-Philbrook
1London Kidney Research Unit, Division of Nephrology, London Health Sciences Centre, ON, Canada.
Rheumatology (Oxford, England)
|January 11, 2008
Summary
Severe bacterial gastroenteritis, like from E. coli, increases the risk of developing arthritis symptoms later. This study found a link between acute diarrhea severity and subsequent joint pain, but not medication use.
Area of Science:
- Infectious Disease Epidemiology
- Rheumatology
- Public Health
Background:
- Reactive arthritis (ReA) can follow bacterial gastroenteritis.
- Outbreaks of E. coli O157:H7 and Campylobacter species in water supplies provide opportunities to study ReA risk.
- The relationship between gastroenteritis severity and subsequent arthritis is not fully understood.
Purpose of the Study:
- To investigate the risk of developing arthritis after bacterial gastroenteritis.
- To examine the association between the severity of acute diarrhea and the incidence of arthritis symptoms.
- To determine if gastroenteritis severity influences the need for arthritis medication.
Main Methods:
- A long-term follow-up study of 2299 participants after a waterborne outbreak of E. coli and Campylobacter.
- Participants were categorized by gastroenteritis symptom severity: asymptomatic, moderate, or severe.
- Arthritis outcomes were self-reported new-onset arthritis or new prescriptions for arthritis medication over a mean 4.5-year follow-up.
Main Results:
- Arthritis was reported in 15.7% of asymptomatic, 17.6% of moderate, and 21.6% of severe gastroenteritis cases (P-trend=0.009).
- Severe gastroenteritis was associated with a 1.33-fold increased risk of arthritis compared to asymptomatic cases (aRR 1.33, 95% CI 1.07-1.66).
- No significant association was found between gastroenteritis severity and the risk of arthritis medication prescriptions (P=0.49).
Conclusions:
- Acute bacterial gastroenteritis requiring medical attention is linked to an increased risk of arthritic symptoms for up to four years.
- The study did not find a correlation between gastroenteritis severity and the prescription of arthritis medications.
- Further research is needed to understand the nature and chronicity of these post-infectious arthritic symptoms.
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