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Post-Infectious Irritable Bowel Syndrome

Current Gastroenterology Reports volume 19, Article number: 56 (2017) Cite this article

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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Authors and Affiliations

  1. School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia

    Yeong Yeh Lee

  2. Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia

    Chandramouli Annamalai

  3. Section of Gastroenterology/Hepatology, Department of Internal Medicine, Medical College of Georgia, AD 2226, Digestive Health Center, Augusta University, 1481 Laney-Walker Blvd, Augusta, GA, 30912, USA

    Satish S. C. Rao

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  3. Satish S. C. Rao
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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 does not contain any studies with human or animal subjects performed by any of the authors.

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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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  • DOI: https://doi.org/10.1007/s11894-017-0595-4

Keywords

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