Yeong Yeh Lee1, Chandramouli Annamalai2, Satish S C Rao3. 1. School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. 2. Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia. 3. Section of Gastroenterology/Hepatology, Department of Internal Medicine, Medical College of Georgia, AD 2226, Digestive Health Center, Augusta University, 1481 Laney-Walker Blvd, Augusta, GA, 30912, USA. srao@augusta.edu.
Abstract
PURPOSE OF REVIEW: Post-infectious irritable bowel syndrome (PI-IBS) is characterized by persistent abdominal pain and diarrhea, typically following an episode of infectious gastroenteritis. The mechanisms that underlie IBS-D remain elusive, but PI-IBS provides a mechanistic model of this disorder. This review provides an up-to-date appraisal of the pathophysiology, clinical features, and management approaches for PI-IBS. RECENT FINDINGS: Disordered immune reactions and release of cytokines with resultant gut inflammation and dysfunction appear to be key features of PI-IBS. Disordered brain-gut-microbiota interactions, type of infecting agent, and host-genetic susceptibility are risk factors but also are reasons for the varying spectrum of clinical severity. Although prognosis is generally good, symptoms and inflammation may persist for a long time. Symptomatic relief with antidiarrheals, antispasmodics, 5HT3 antagonists, mesalamine, probiotics, and low-dose antidepressants remain the primary approaches, but in some difficult cases, a combination of drugs that target the pathophysiology may be helpful. PI-IBS has many overlapping features with IBS-D and shares similar pathophysiology and management approaches.
PURPOSE OF REVIEW: Post-infectious irritable bowel syndrome (PI-IBS) is characterized by persistent abdominal pain and diarrhea, typically following an episode of infectious gastroenteritis. The mechanisms that underlie IBS-D remain elusive, but PI-IBS provides a mechanistic model of this disorder. This review provides an up-to-date appraisal of the pathophysiology, clinical features, and management approaches for PI-IBS. RECENT FINDINGS:Disordered immune reactions and release of cytokines with resultant gut inflammation and dysfunction appear to be key features of PI-IBS. Disordered brain-gut-microbiota interactions, type of infecting agent, and host-genetic susceptibility are risk factors but also are reasons for the varying spectrum of clinical severity. Although prognosis is generally good, symptoms and inflammation may persist for a long time. Symptomatic relief with antidiarrheals, antispasmodics, 5HT3 antagonists, mesalamine, probiotics, and low-dose antidepressants remain the primary approaches, but in some difficult cases, a combination of drugs that target the pathophysiology may be helpful. PI-IBS has many overlapping features with IBS-D and shares similar pathophysiology and management approaches.
Authors: Mark R Borgaonkar; David C Ford; John K Marshall; Elizabeth Churchill; Stephen M Collins Journal: Dig Dis Sci Date: 2006-06-07 Impact factor: 3.199
Authors: Alexandra-Chloé Villani; Mathieu Lemire; Marroon Thabane; Alexandre Belisle; Geneviève Geneau; Amit X Garg; William F Clark; Paul Moayyedi; Stephen M Collins; Denis Franchimont; John K Marshall Journal: Gastroenterology Date: 2010-01-04 Impact factor: 22.682
Authors: Yasuaki Motomura; Waliul I Khan; Rami T El-Sharkawy; Monica Verma-Gandhu; Richard K Grencis; Stephen M Collins Journal: Am J Physiol Gastrointest Liver Physiol Date: 2010-09-23 Impact factor: 4.052
Authors: E F Verdú; P Bercik; M Verma-Gandhu; X-X Huang; P Blennerhassett; W Jackson; Y Mao; L Wang; F Rochat; S M Collins Journal: Gut Date: 2005-08-16 Impact factor: 23.059
Authors: Raphaela I Lau; Fen Zhang; Qin Liu; Qi Su; Francis K L Chan; Siew C Ng Journal: Nat Rev Gastroenterol Hepatol Date: 2022-10-21 Impact factor: 73.082
Authors: NurFadhilah Yusof; Nurhazwani Hamid; Zheng Feei Ma; Rona Marie Lawenko; Wan Mohd Zahiruddin Wan Mohammad; Deirdre A Collins; Min Tze Liong; Toshitaka Odamaki; Jinzhong Xiao; Yeong Yeh Lee Journal: Gut Pathog Date: 2017-12-14 Impact factor: 4.181