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05-10-2010 | Gastroenterology | Article

Infectious gastroenteritis linked to functional gastrointestinal disorders

Abstract

Free abstract

MedWire News: Patients with infectious gastroenteritis (IGE) have an increased risk for subsequent functional gastrointestinal disorders (FGDs), show study results.

The term FGDs is used to describe a group of chronic or recurrent gastrointestinal symptoms with no identified underlying pathoetiology that account for four out of every 100 ambulatory care visits in the USA, making them "one of the most costly and burdensome group of gastrointestinal disorders with considerable societal impact," say researchers.

To investigate whether prior IGE, including bacterial (with or without a specified pathogen), protozoal, and viral infection, is associated with increased risk for FGDs, Mark Riddle (Naval Medical Research Center, Silver Spring, Maryland, USA) and colleagues collected data from 31,866 active duty military personnel who reported FGDs between 1999 and 2007.

Reported FGDs included irritable bowel syndrome (IBS; n=9091), functional constipation (FC; n=17,538), functional diarrhea (FD; n=674), and dyspepsia (n=6750).

In total, 1.2%, 38.9%, 0.7%, and 61.9% of the patients who reported FGDs had prior specific bacterial, nonspecific bacterial, protozoal, and viral IGE, respectively.

As reported in the American Journal of Gastroenterology, Riddle and team found that prior IGE increased the relative risk for all FGDs a significant 2.64-fold.

When divided by specific FGDs, the risk associated with prior IGE was highest for FD, at an odds ratio (OR) of 6.28 compared with no previous IGE. The ORs for IBS, FC, and dyspepsia associated with prior IGE were 3.72, 2.15, and 2.39, respectively.

Bacterial type IGE was generally associated with a greater risk for subsequent FGDs than other IGE infection types. In addition, risk for FGD development decreased with increasing time from initial IGE infection.

"Several studies have linked acute enteric infections with post-infectious IBS," explain Riddle et al.

In this study, "additional to IBS, other functional disorders were noted to be associated with antecedent acute gastroenteritis," the researchers add.

They conclude: "When considering effective countermeasures and mitigation strategies, attention directed toward prevention as well as the acute and chronic sequelae of these infections is needed."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert