Acute gastroenteritis infection associated with later IBS, functional dyspepsia, review finds
Prevalence of irritable bowel disease and functional dyspepsia were 14.5% and 12.7%, respectively, in patients who had experienced acute gastroenteritis, a risk more than three times higher than that in uninfected patients.
Patients who have had acute gastroenteritis had a more than fourfold increased risk of irritable bowel syndrome (IBS) and a threefold increased risk of functional dyspepsia after their infection, a systematic review and meta-analysis found.
Researchers assessed data from 47 studies enrolling 28,170 participants to determine the prevalence of IBS (46 studies) or functional dyspepsia (13 studies) after acute gastroenteritis. All studies were observational, had a follow-up of at least three months, and enrolled at least 50 adults. Results were published by Gut on July 16.
Prevalence of IBS and functional dyspepsia were 14.5% (95% CI, 11.2% to 18.1%) and 12.7% (95% CI, 6.6% to 20.4%), respectively. IBS persisted in 39.8% of patients during a follow-up period of more than five years after gastroenteritis diagnosis. Female sex, history of anxiety, and hospitalization were all associated with an increased risk of IBS. Compared with nonexposed controls, patients with acute gastroenteritis had significantly higher risk for IBS and dyspepsia (odds ratios [ORs], 4.3 and 3.0, respectively).
IBS was most commonly associated with infection due to parasites (30.1%), but that finding came from only two studies. Other common associations were bacteria (18.3%) and viruses (10.7%). Campylobacter infection was associated with the highest IBS prevalence (20.7%), but infection with proteobacteria and SARS-CoV-2 yielded the highest odds for postinfection IBS (OR, 5.4 for both). The prevalence of functional dyspepsia was 10.0% for gastroenteritis due to SARS-CoV-2 and 13.6% for bacteria.
One limitation to the review is that most studies had moderate to high heterogeneity. Most studies also included data from Western populations, and researchers had limited data on specific pathogens.
"Our findings are important conceptually, as they support the gradual switch in envisioning [disorders of gut-brain interaction] from functional to organic disorders, as microbial factors may be considered equally as important to neuroimmune interactions," the researchers wrote.