Risk Factors of Developing Postinfectious Irritable Bowel Syndrome in Shigellosis Patients, 5 Years After Hospitalization During the Outbreak.

Maryam Soheilipour, Atefeh Chahichi, Hamid Mohajer, Niousha Ghomashi, Hamidreza Roohafza, Peyman Adibi
Author Information
  1. Maryam Soheilipour: Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
  2. Atefeh Chahichi: Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. ORCID
  3. Hamid Mohajer: Faculty of Medical School, Najafabad Branch, Islamic Azad University, Isfahan, Iran.
  4. Niousha Ghomashi: School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
  5. Hamidreza Roohafza: Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
  6. Peyman Adibi: Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Irritable Bowel Syndrome (IBS) can be triggered by bacterial dysentery. This study aimed to investigate postinfectious IBS and its risk factors after the shigellosis outbreak in hospitalized patients.
Methods: This retrospective study was conducted in 2020-2021 in referral hospitals for gastroenteritis during the 2014 shigellosis outbreak in Isfahan. The -infected group included hospitalized shigellosis patients with clinical symptoms and positive stool culture. The control group included patients matched pairwise on age and sex to the -infected group, admitted to the same hospitals in the same period with diagnoses other than shigellosis. Both groups had no history of diagnosed IBS before the outbreak. The incidence of IBS (according to Rome-III criteria) and its related factors was compared between the 2 groups 5 years after infection.
Results: Of 619 participants, 220 (35.5%) were in the -infected group. The 5-year incidence of IBS was 31.8% and 5.7% in the -infected and control groups, respectively. Multivariate analysis showed that shigellosis was significantly associated with increased risk of IBS (odds ratio [OR], 17.18 [95% confidence interval {CI}, 9.37-31.48]). Multivariate analysis indicated education level (OR, 4.15 [95% CI, 1.47-11.73]), diarrhea lasting >4 days (OR, 1.69 [95% CI, 1.17-2.44]), and abdominal cramps during the infection (OR, 0.27 [95% CI, .77-.95]) associated with postinfectious IBS ( < .05).
Conclusions: Hospitalized patients with gastroenteritis are at increased risk of IBS within 5 years after infection. Factors such as higher education level and the absence of abdominal cramps and diarrhea persisting for >5 days during hospitalization can further increase this risk.

Keywords

References

  1. Neurogastroenterol Motil. 2008 Sep;20(9):1022-9 [PMID: 18492027]
  2. Dig Dis Sci. 2021 Jul;66(7):2323-2335 [PMID: 32772204]
  3. Am J Gastroenterol. 2004 May;99(5):924-31 [PMID: 15128362]
  4. Cureus. 2021 Jun 28;13(6):e15979 [PMID: 34336470]
  5. Best Pract Res Clin Gastroenterol. 2019 Jun - Aug;40-41:101620 [PMID: 31594651]
  6. Aliment Pharmacol Ther. 2007 Aug 15;26(4):535-44 [PMID: 17661757]
  7. Aliment Pharmacol Ther. 2005 Nov 15;22(10):935-42 [PMID: 16268967]
  8. Epidemiol Health. 2017 Feb 1;39:e2017005 [PMID: 28171714]
  9. Gastroenterology. 2021 Jan;160(1):99-114.e3 [PMID: 32294476]
  10. Exp Ther Med. 2020 Oct;20(4):3517-3522 [PMID: 32905134]
  11. Nat Rev Gastroenterol Hepatol. 2020 Aug;17(8):473-486 [PMID: 32296140]
  12. Rev Bras Med Trab. 2019 Dec 01;17(4):530-536 [PMID: 32685752]
  13. Aliment Pharmacol Ther. 2016 Sep;44(6):576-82 [PMID: 27444134]
  14. Iran J Psychiatry. 2019 Apr;14(2):137-146 [PMID: 31440295]
  15. Scand J Gastroenterol. 2019 May;54(5):546-562 [PMID: 31112663]
  16. J Gastroenterol Hepatol. 2005 Mar;20(3):381-6 [PMID: 15740480]
  17. Ann Med Health Sci Res. 2013 Jul;3(3):391-6 [PMID: 24116320]
  18. Lancet Gastroenterol Hepatol. 2020 Oct;5(10):908-917 [PMID: 32702295]
  19. Korean J Gastroenterol. 2012 Jul;60(1):13-8 [PMID: 22832795]
  20. Am J Gastroenterol. 2018 Sep;113(9):1363-1375 [PMID: 30171215]
  21. Prim Care. 2017 Dec;44(4):655-671 [PMID: 29132527]
  22. J Clin Gastroenterol. 2009 Jul;43(6):534-40 [PMID: 19262407]
  23. J Gastrointestin Liver Dis. 2021 Sep 21;30(3):334-338 [PMID: 34551031]
  24. Ann Gastroenterol. 2019 Nov-Dec;32(6):554-564 [PMID: 31700231]
  25. Gut. 2017 Jun;66(6):1075-1082 [PMID: 26818616]
  26. BMC Gastroenterol. 2017 Dec 2;17(1):137 [PMID: 29197339]
  27. Gastroenterol Rep. 2007 Winter;1(2):56-65 [PMID: 21544252]
  28. Middle East J Dig Dis. 2022 Jul;14(3):304-309 [PMID: 36619262]
  29. Gastroenterology. 2017 Apr;152(5):1042-1054.e1 [PMID: 28069350]
  30. Gastroenterology. 2015 Nov;149(6):1408-14 [PMID: 26255560]
  31. Perspect Clin Res. 2015 Oct-Dec;6(4):222-4 [PMID: 26623395]
  32. JAMA. 2015 Mar 3;313(9):949-58 [PMID: 25734736]
  33. Front Med (Lausanne). 2018 Jan 29;5:11 [PMID: 29435450]
  34. United European Gastroenterol J. 2018 Oct;6(8):1245-1253 [PMID: 30288287]
  35. Front Public Health. 2023 May 18;11:1169764 [PMID: 37275504]
  36. Gut. 2004 Aug;53(8):1096-101 [PMID: 15247174]
  37. J Neurogastroenterol Motil. 2016 Jul 30;22(3):490-6 [PMID: 26908484]
  38. Aliment Pharmacol Ther. 2004 Jun 1;19(11):1217-24 [PMID: 15153175]
  39. Iran J Psychiatry. 2018 Apr;13(2):94-102 [PMID: 29997654]
  40. Gastroenterology. 2009 May;136(6):1979-88 [PMID: 19457422]

Word Cloud

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