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A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India

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Abstract

Background and Aim

Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score.

Methods

This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested.

Results

Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively.

Conclusion

One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.

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Authors and Affiliations

  1. Department of Gastroenterology, S C B Medical College, Cuttack, 753 007, India

    Prasanta Kumar Parida, Debakanta Mishra, Kaibalya Ranjan Dash, Sambit Kumar Behera, Suryakanta Parida, Chitta Ranjan Khatua, Subhendu Panigrahi & Shivaram Prasad Singh

  2. Department of Gastroenterology, Institute of Medical Sciences and SUM Hospital, K8 Kalinga Nagar, Shampur, Bhubaneswar, 751 003, India

    Girish Kumar Pati

  3. Department of Gastroenterology, Kalinga Institute of Medical Science, KIIT Road, Patia, Bhubaneswar, 751 024, India

    Preetam Nath

  4. Regional Medical Research Centre (RMRC), Chandrasekharpur, Bhubaneswar, 751 023, India

    Amarendra Mahapatra & Hemant Kumar Khuntia

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  1. Prasanta Kumar Parida
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Contributions

Prasanta Kumar Parida: Collecting data; analysis of data; preparing the initial draft of the manuscript.

Girish Kumar Pati: Preparing the initial draft of the manuscript.

Debakanta Mishra: Analysis of data; preparing the initial draft of the manuscript; critical revision of the manuscript for intellectual content.

Preetam Nath: Study concept and protocol design; analysis of data.

Kaibalya Ranjan Dash: Collecting data; preparing the initial draft of the manuscript.

Sambit Kumar Behera: Critical revision of the manuscript for intellectual content.

Suryakanta Parida: Collecting data; preparing the initial draft of the manuscript.

Chitta Ranjan Khatua: Analysis of data; preparing the initial draft of the manuscript.

Subhendu Panigrahi: Collecting data.

Amarendra Mahapatra: Stool culture and microbiological analysis.

Hemant Kumar Khuntia: Stool culture and microbiological analysis.

Prof. Shivaram Prasad Singh: Study concept and protocol design; study supervision.

Corresponding author

Correspondence to Shivaram Prasad Singh.

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Conflict of interest

PKP, DM, GKP, PN, KRD, SKB, SP, CRK, SP, AM, HKK, and SPS declare that they have no conflict of interest.

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The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown in Springer.com.

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Parida, P.K., Mishra, D., Pati, G.K. et al. A prospective study on incidence, risk factors, and validation of a risk score for post-infection irritable bowel syndrome in coastal eastern India. Indian J Gastroenterol 38, 134–142 (2019). https://doi.org/10.1007/s12664-019-00943-w

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  • DOI: https://doi.org/10.1007/s12664-019-00943-w

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