Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
Aliment Pharmacol Ther. 2015 Jun;41(11):1029-37. doi: 10.1111/apt.13199. Epub 2015 Apr 13.
Gastrointestinal infection is known as a risk factor for the development of the irritable bowel syndrome (post-infectious irritable bowel syndrome, PI-IBS). The incidence of PI-IBS ranges between 3% and over 30% of people after infectious gastroenteritis.
To perform a meta-analysis pools and report data concerning the relative risk (RR) of PI-IBS after TD.
Database search using Medline through PubMed, Scopus, EBM Reviews (Cochrane Database of Systematic Reviews) and PsycINFO was performed to identify relevant studies. Those that met the inclusion criteria were pooled. A random effects model (Mantel-Haenszel) was performed.
Six eligible studies were found. In three of six studies, the authors reported a statistically significant association of TD and PI-IBS. The pooled RR was 3.35 (95% CI: 2.22-5.05) with a significant overall effect (P < 0.00001). Overall PI-IBS incidence was 5.4% in TD subjects and 1.4% in healthy subjects. There was no significant heterogeneity within the pooled studies (I(2) = 5%). Self-reported TD alone resulted in an over 1.5-fold RR for PI-IBS compared to laboratory-confirmed TD [RR 3.90 (95% CI: 2.35-6.49) vs. RR 2.42 (95% CI: 1.22-4.78)].
There is a strong association between travellers' diarrhoea and post-infectious irritable bowel syndrome. Self-reports of exposure seem to result in a higher post-infectious irritable bowel syndrome occurrence than laboratory-confirmed cases of travellers' diarrhoea, but further studies are needed to confirm this finding. Finally, potential influences of the selection of an appropriate study population on post-infectious irritable bowel syndrome epidemiology are discussed.
胃肠道感染被认为是肠易激综合征（感染后肠易激综合征，PI-IBS）发展的一个危险因素。感染性胃肠炎后，PI-IBS 的发病率在 3%至 30%以上不等。
对旅行者腹泻（TD）后发生 PI-IBS 的相对风险（RR）进行荟萃分析和数据报告。
通过 Medline 检索 PubMed、Scopus、EBM Reviews（Cochrane 系统评价数据库）和 PsycINFO 数据库，以确定相关研究。符合纳入标准的研究进行汇总。采用随机效应模型（Mantel-Haenszel）进行分析。
共发现 6 项符合条件的研究。在 6 项研究中的 3 项中，作者报道了 TD 与 PI-IBS 之间存在统计学显著关联。汇总 RR 为 3.35（95%CI：2.22-5.05），总体效应具有统计学意义（P<0.00001）。TD 组的总体 PI-IBS 发生率为 5.4%，健康对照组为 1.4%。汇总研究中无显著异质性（I²=5%）。与实验室确诊的 TD 相比，仅自我报告的 TD 导致 PI-IBS 的 RR 超过 1.5 倍[RR 3.90（95%CI：2.35-6.49）比 RR 2.42（95%CI：1.22-4.78）]。
旅行者腹泻与感染后肠易激综合征之间存在很强的关联。与实验室确诊的 TD 相比，自我报告的 TD 似乎导致更高的感染后肠易激综合征发生率，但需要进一步的研究来证实这一发现。最后，讨论了选择适当的研究人群对感染后肠易激综合征流行病学的潜在影响。
