| Post-infectious irritable bowel syndrome: the past, the present and the future. | |
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MedLine Citation:
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PMID: 21443719 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Irritable bowel syndrome (IBS), once thought to be a psychosomatic disease, is being considered to be more organic. Post-infectious IBS (PI-IBS), defined as acute onset IBS (by Rome criteria) after gastrointestinal infection in an individual without prior IBS with two or more of the followings: fever, vomiting, diarrhea, a positive stool culture. The recent and old literature of PI-IBS will be reviewed. Future directions for research will be presented. METHODS: Literature on PI-IBS was reviewed by electronic search and cross references of these papers. RESULTS: Interest in studies on PI-IBS, which was described five to six decades ago, re-surfaced recently. 3.6 to 32% patients with acute gastroenteritis develop PI-IBS during 3-12 month follow-up. PI-IBS is commonly diarrhea predominant. Factors implicated in development include nature of pathogens, duration and severity of diarrhea, younger age, female gender and psychological co-morbidities like anxiety and depression. The pathogenesis of PI-IBS is largely related to continuing gut inflammation due to inability of the host to contain the inflammatory reaction, altered gut microbiota, increased intestinal permeability, muscle hyper-contractility and visceral hypersensitivity. There could be an overlap between PI-IBS and post-infectious malabsorption syndrome (PI-MAS), popularly known as tropical sprue. CONCLUSIONS: Development of IBS in a subset of patients with acute gastroenteritis is uncontested. This is expected to open a paradigm shift in understanding the pathogenesis of IBS. Future studies should address the issue of overlap of PI-IBS and PI-MAS. Exploring the molecular mechanisms of pathogenesis of PI-IBS may help to design preventive and therapeutic strategies. |
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Authors:
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Uday C Ghoshal; Prabhat Ranjan |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of gastroenterology and hepatology Volume: 26 Suppl 3 ISSN: 1440-1746 ISO Abbreviation: J. Gastroenterol. Hepatol. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607909 Medline TA: J Gastroenterol Hepatol Country: Australia |
Other Details:
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Languages: eng Pagination: 94-101 Citation Subset: IM |
Copyright Information:
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© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd. |
Affiliation:
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Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. udayghoshal@gmail.com |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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