BACKGROUND: Postinfectious irritable bowel syndrome (PI-IBS) has been reported as a complication of bacterial diarrhea including travelers' diarrhea (TD). This study assessed the role of TD among US students in Mexico in triggering the onset of persistent abdominal symptoms (PAS) and IBS. METHODS: We conducted a 6-month follow-up of a cohort of 817 US students in Mexico as short-term study to assess the frequency of PAS and IBS. Using Rome II criteria for IBS, groups of students with PAS were then categorized as PI-IBS if they met the symptom criteria for IBS or as suffering from functional abdominal disorder (FAD) if they did not meet the criteria. RESULTS: FAD and IBS were commonly found in US students 6 months after leaving Mexico. Important variables in their development were younger adult age, longer stays in Mexico and occurrence of acute diarrhea while in Mexico. Diarrhea while in Mexico occurred more commonly for those later diagnosed with FAD, 101/196 (52%), relative risk (RR) = 1.5 [confidence interval (CI) 1.2-1.8; p = 0.001]; IBS, 20/32 (63%), RR = 2.5 (CI 1.2-5.0; p = 0.007); and PAS (FAD + IBS), 121/228 (53%), RR = 1.5 (CI 1.2-1.8; p < 0.001) compared with subjects who had experienced diarrhea while in Mexico but were not diagnosed with PAS at 6 months, 227/589 (39%). Diarrhea caused by heat-labile enterotoxin-producing enterotoxigenic Escherichia coli or Providencia ssp. demonstrated a greater risk of developing PAS. CONCLUSIONS: PAS occurred commonly in a subset of younger adult travelers who stayed longer in Mexico and experienced acute diarrhea while there. Further studies with this cohort will focus on host genetic associations with the development of PAS.
BACKGROUND: Postinfectious irritable bowel syndrome (PI-IBS) has been reported as a complication of bacterial diarrhea including travelers' diarrhea (TD). This study assessed the role of TD among US students in Mexico in triggering the onset of persistent abdominal symptoms (PAS) and IBS. METHODS: We conducted a 6-month follow-up of a cohort of 817 US students in Mexico as short-term study to assess the frequency of PAS and IBS. Using Rome II criteria for IBS, groups of students with PAS were then categorized as PI-IBS if they met the symptom criteria for IBS or as suffering from functional abdominal disorder (FAD) if they did not meet the criteria. RESULTS: FAD and IBS were commonly found in US students 6 months after leaving Mexico. Important variables in their development were younger adult age, longer stays in Mexico and occurrence of acute diarrhea while in Mexico. Diarrhea while in Mexico occurred more commonly for those later diagnosed with FAD, 101/196 (52%), relative risk (RR) = 1.5 [confidence interval (CI) 1.2-1.8; p = 0.001]; IBS, 20/32 (63%), RR = 2.5 (CI 1.2-5.0; p = 0.007); and PAS (FAD + IBS), 121/228 (53%), RR = 1.5 (CI 1.2-1.8; p < 0.001) compared with subjects who had experienced diarrhea while in Mexico but were not diagnosed with PAS at 6 months, 227/589 (39%). Diarrhea caused by heat-labile enterotoxin-producing enterotoxigenic Escherichia coli or Providencia ssp. demonstrated a greater risk of developing PAS. CONCLUSIONS:PAS occurred commonly in a subset of younger adult travelers who stayed longer in Mexico and experienced acute diarrhea while there. Further studies with this cohort will focus on host genetic associations with the development of PAS.
Authors: Renee M Laird; Zuchao Ma; Nelum Dorabawila; Brittany Pequegnat; Eman Omari; Yang Liu; Alexander C Maue; Steven T Poole; Milton Maciel; Kavyashree Satish; Christina L Gariepy; Nina M Schumack; Annette L McVeigh; Frédéric Poly; Cheryl P Ewing; Michael G Prouty; Mario A Monteiro; Stephen J Savarino; Patricia Guerry Journal: Vaccine Date: 2018-09-27 Impact factor: 3.641
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: Mark S Riddle; Bradley A Connor; Nicholas J Beeching; Herbert L DuPont; Davidson H Hamer; Phyllis Kozarsky; Michael Libman; Robert Steffen; David Taylor; David R Tribble; Jordi Vila; Philipp Zanger; Charles D Ericsson Journal: J Travel Med Date: 2017-04-01 Impact factor: 8.490
Authors: Lisa Lindsay; Herbert L DuPont; Christine L Moe; Martin Alberer; Christoph Hatz; Amy E Kirby; Henry M Wu; Thomas Verstraeten; Robert Steffen Journal: BMC Infect Dis Date: 2018-12-03 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