BACKGROUND: Travelers' diarrhea (TD) remains a frequent travel-associated infection. Between 4 and 32% of enteric infections were followed by a postinfectious irritable bowel syndrome (pIBS) with long-term sequelae in various settings. Travel-related IBS incidence rates are based on small studies and IBS predictors have not been sufficiently evaluated. METHODS: Adult travelers to resource-limited destinations participated in a prospective questionnaire-based cohort study. Demographics, travel characteristics, and medical history were assessed and those with functional or organic gastrointestinal disorders were excluded. Immediately after return from abroad, the volunteers completed a second questionnaire on TD, other health impairments, and on nutritional hygiene. Six-months post-travel, a follow-up questionnaire assessed IBS based on Rome III criteria. Risk factors were analyzed by multiple logistic regression. RESULTS: Among a total of 2,476 subjects analyzed (participation rate 72.4%), 38 (1.5%) developed new IBS, and the 6-month incidence rate for pIBS was 3.0% (95% CI 1.9-4.2) following TD. Significant risk factors were TD during the surveyed journey (OR 3.7; 95% 1.8-7.4), an adverse life event experienced within 12 months pre-travel (OR 3.1; 1.4-6.8), and a diarrheal episode experienced within 4 months pre-travel (OR 2.7; 95% CI 1.3-5.6). Following multiple diarrheal episodes, the risk of acquiring IBS increased by six times. CONCLUSIONS: In a large population of European travelers IBS had a lower incidence rate as compared to previous studies. Particular risk groups were identified; those may need to be protected.
BACKGROUND: Travelers' diarrhea (TD) remains a frequent travel-associated infection. Between 4 and 32% of enteric infections were followed by a postinfectious irritable bowel syndrome (pIBS) with long-term sequelae in various settings. Travel-related IBS incidence rates are based on small studies and IBS predictors have not been sufficiently evaluated. METHODS: Adult travelers to resource-limited destinations participated in a prospective questionnaire-based cohort study. Demographics, travel characteristics, and medical history were assessed and those with functional or organic gastrointestinal disorders were excluded. Immediately after return from abroad, the volunteers completed a second questionnaire on TD, other health impairments, and on nutritional hygiene. Six-months post-travel, a follow-up questionnaire assessed IBS based on Rome III criteria. Risk factors were analyzed by multiple logistic regression. RESULTS: Among a total of 2,476 subjects analyzed (participation rate 72.4%), 38 (1.5%) developed new IBS, and the 6-month incidence rate for pIBS was 3.0% (95% CI 1.9-4.2) following TD. Significant risk factors were TD during the surveyed journey (OR 3.7; 95% 1.8-7.4), an adverse life event experienced within 12 months pre-travel (OR 3.1; 1.4-6.8), and a diarrheal episode experienced within 4 months pre-travel (OR 2.7; 95% CI 1.3-5.6). Following multiple diarrheal episodes, the risk of acquiring IBS increased by six times. CONCLUSIONS: In a large population of European travelers IBS had a lower incidence rate as compared to previous studies. Particular risk groups were identified; those may need to be protected.
Authors: Stefan H F Hagmann; Pauline V Han; William M Stauffer; Andy O Miller; Bradley A Connor; DeVon C Hale; Christina M Coyle; John D Cahill; Cinzia Marano; Douglas H Esposito; Phyllis E Kozarsky Journal: Fam Pract Date: 2014-09-26 Impact factor: 2.267
Authors: Tahaniyat Lalani; Jason D Maguire; Edward M Grant; Jamie Fraser; Anuradha Ganesan; Mark D Johnson; Robert G Deiss; Mark S Riddle; Timothy Burgess; David R Tribble Journal: J Travel Med Date: 2014-12-07 Impact factor: 8.490
Authors: Louis Tapper; Sophie Skarbek; Robert A Lever; Peter L Chiodini; Margaret Armstrong; Robin L Bailey Journal: BMC Infect Dis Date: 2021-06-23 Impact factor: 3.090
Authors: Kristen Pogreba-Brown; Erika Austhof; Alexandra Armstrong; Kenzie Schaefer; Lorenzo Villa Zapata; D Jean McClelland; Michael B Batz; Maria Kuecken; Mark Riddle; Chad K Porter; Michael C Bazaco Journal: Foodborne Pathog Dis Date: 2019-10-07 Impact factor: 3.788