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Post-infectious irritable bowel syndrome in a paediatric population: first data in a Middle Eastern country
Sara Mina1, Sara Daher2, Sara Jamal Elddin3
1Department of Medical Laboratory Sciences, Faculty of Health Sciences, Beirut Arab University, Beirut, 11-5020, Lebanon. s.mina@bau.edu.lb.
Insights
Acute gastroenteritis (AGE) in children can lead to post-infection irritable bowel syndrome (PI-IBS). Rotavirus caused severe AGE, while parasitic and bacterial infections showed higher CRP levels, correlating with PI-IBS development.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Clinical Research
Background:
- Acute gastroenteritis (AGE) is a leading cause of hospitalization and mortality in children globally.
- AGE is recognized as a risk factor for developing post-infection irritable bowel syndrome (PI-IBS).
- Understanding the link between AGE etiology and PI-IBS is crucial for pediatric health.
Purpose of the Study:
- To correlate the clinical severity of AGE with specific infectious agents.
- To investigate the occurrence of PI-IBS in North Lebanese children and adolescents following AGE.
- To identify potential risk factors for PI-IBS development after AGE.
Main Methods:
- 219 pediatric patients (4-15 years) with gastrointestinal complaints were enrolled.
- Stool samples were analyzed for microbiological agents; AGE severity was scored using the Vesikari scale.
- Patients were monitored for PI-IBS development using Rome IV criteria and Bristol Stool Scale.
Main Results:
- Viral pathogens were most common (26.9%), with rotavirus linked to severe AGE (25.1%).
- Parasitic and bacterial AGE cases showed elevated C-reactive protein (CRP) levels (p=0.009).
- 13.24% of patients developed PI-IBS, predominantly with mixed bowel habits (IBS-M).
Conclusions:
- This study offers preliminary insights into PI-IBS development in Lebanese pediatric populations.
- Specific AGE etiologies may influence PI-IBS risk and severity.
- Further research is needed to elucidate PI-IBS pathogenesis and prevention strategies.
Background:
Acute gastroenteritis (AGE) is the second most common cause of paediatric hospitalizations and mortality worldwide. The type of etiological agent determines its clinical severity. Interestingly, AGE has been shown as a risk factor for the development of post-infection irritable bowel syndrome (PI-IBS). In this study, we aimed to correlate the clinical severity of AGE for different infectious etiologies with the occurrence of PI-IBS in North Lebanese children and adolescents.
Methods:
A total of 219 patients admitted with gastrointestinal complaints, aged between four and 15 years, were enrolled in this study. For each patient, a stool sample was obtained for microbiological analysis. Data on demographic and socioeconomic characteristics, and clinical history were collected. AGE severity was evaluated using the Vesikari Clinical Severity Scoring System. The patients were then followed to assess the development of PI-IBS, using the Bristol stool form scale and the Rome IV diagnostic criteria.
Results:
Viral pathogens were the predominant etiological agents of AGE (26.9%), followed by parasites (8.2%), and Salmonella spp. (4.6%). Of all the pathogens identified in this study, rotavirus was the predominant infectious agent (25.1%) associated with severe AGE. Children with parasitic or bacterial AGE had significantly higher C-reactive protein (CRP) average levels (p = 0.009). Moreover, 29 patients (13.24%) met the Rome IV criteria for PI-IBS, with mixed bowel habits (IBS-M) (48.3%) as the most frequent subtype.
Conclusion:
This study provided novel preliminary data on the development of PI-IBS in Lebanese children and adolescents. Further studies are needed to explore the pathogenesis of PI-IBS and possible prevention strategies.
Clinical Trial Number:
Not applicable.
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