Parida Prasanta Kumar, Mishra Debakanta, Pati Girish Kumar, Nath Preetam, Dash Kaibalya Ranjan, Behera Sambit Kumar, Parida Suryakanta, Khatua Chitta Ranjan, Panigrahi Subhendu, Mahapatra Amarendra, Khuntia Hemant Kumar, Singh Shivaram Prasad
Department of Gastroenterology, S C B Medical College, Cuttack, 753 007, India.
Department of Gastroenterology, Institute of Medical Sciences and SUM Hospital, K8 Kalinga Nagar, Shampur, Bhubaneswar, 751 003, India.
Indian J Gastroenterol. 2019 Apr;38(2):134-142. doi: 10.1007/s12664-019-00943-w. Epub 2019 Apr 4.
BACKGROUND AND AIM: Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score. METHODS: This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested. RESULTS: Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively. CONCLUSION: One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.
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