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Post-Infectious Irritable Bowel Syndrome

Abstract

Purpose of Review

Post-infectious irritable bowel syndrome (PI-IBS) is characterized by persistent abdominal pain and diarrhea, typically following an episode of infectious gastroenteritis. The mechanisms that underlie IBS-D remain elusive, but PI-IBS provides a mechanistic model of this disorder. This review provides an up-to-date appraisal of the pathophysiology, clinical features, and management approaches for PI-IBS.

Recent Findings

Disordered immune reactions and release of cytokines with resultant gut inflammation and dysfunction appear to be key features of PI-IBS. Disordered brain-gut-microbiota interactions, type of infecting agent, and host-genetic susceptibility are risk factors but also are reasons for the varying spectrum of clinical severity. Although prognosis is generally good, symptoms and inflammation may persist for a long time. Symptomatic relief with antidiarrheals, antispasmodics, 5HT3 antagonists, mesalamine, probiotics, and low-dose antidepressants remain the primary approaches, but in some difficult cases, a combination of drugs that target the pathophysiology may be helpful.

Summary

PI-IBS has many overlapping features with IBS-D and shares similar pathophysiology and management approaches.

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Acknowledgements

This work was supported by the Fundamental Research Grant Scheme of Ministry of Education of Malaysia (reference: 203.PPSP.6171183 and 203.PPSP.6171192).

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Correspondence to Satish S. C. Rao.

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Yeong Yeh Lee, Chandramouli Annamalai, and Satish S. C. Rao declare no conflict of interest.

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This article is part of the Topical Collection on Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract

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Lee, Y.Y., Annamalai, C. & Rao, S.S.C. Post-Infectious Irritable Bowel Syndrome. Curr Gastroenterol Rep 19, 56 (2017). https://doi.org/10.1007/s11894-017-0595-4

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Keywords

  • Irritable bowel syndrome
  • Diarrhea
  • Gastroenteritis
  • Pathophysiology
  • Inflammation