Document Detail


Incidence and epidemiology of irritable bowel syndrome after a large waterborne outbreak of bacterial dysentery.
MedLine Citation:
PMID:  16890598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Postinfectious irritable bowel syndrome (PI-IBS) is a common clinical phenomenon. To better define its incidence and epidemiology, a large cohort study was initiated after the contamination of a municipal water supply led to a large outbreak of acute Escherichia coli 0157:H7 and Campylobacter jejuni gastroenteritis. METHODS: Local residents were invited to undergo structured assessments at research clinics established 2 years after the outbreak. Permanent adult residents with no prior history of inflammatory bowel disease or IBS were eligible. Standardized questionnaires defined past and current health. The cohort was divided into controls without gastroenteritis, subjects with clinically suspected gastroenteritis, and subjects with only self-reported gastroenteritis that could not be substantiated by another source. A modified Bowel Disease Questionnaire identified IBS according to Rome criteria. The incidence and epidemiology of PI-IBS was characterized. Risk factors were assessed using multiple logistic regression. RESULTS: There were 2069 eligible study participants. Rome I criteria were met by 71 of 701 controls (10.1%) vs 249 of 904 subjects with self-reported gastroenteritis (27.5%) and 168 of 464 subjects with clinically suspected gastroenteritis (36.2%) (all comparisons, P < 001). Independent risk factors for PI-IBS included younger age, female sex, bloody stools, abdominal cramps, weight loss, and prolonged diarrhea. PI-IBS was more likely than sporadic IBS to show diarrhea-predominant features. CONCLUSIONS: PI-IBS is common after gastroenteritis from water contamination and often is diarrhea-predominant. Characteristics of the acute illness identify patients at increased risk for PI-IBS.
Authors:
John K Marshall; Marroon Thabane; Amit X Garg; William F Clark; Marina Salvadori; Stephen M Collins;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gastroenterology     Volume:  131     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-07     Completed Date:  2006-09-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445-50; quiz 660     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada. marshllj@mcmaster.ca
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MeSH Terms
Descriptor/Qualifier:
Campylobacter Infections / complications,  epidemiology*,  microbiology
Campylobacter jejuni / isolation & purification
Disease Outbreaks*
Dysentery / complications,  epidemiology*,  microbiology
Escherichia coli / isolation & purification
Escherichia coli Infections / complications,  epidemiology*,  microbiology
Female
Follow-Up Studies
Humans
Incidence
Irritable Bowel Syndrome / epidemiology*,  etiology
Male
Middle Aged
Ontario / epidemiology
Questionnaires
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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