Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Gut Liver. 2022 May 15;16(3):331-340. doi: 10.5009/gnl210208.
Following acute gastroenteritis (AGE) due to bacteria, viruses, or protozoa, a subset of patients develop new onset Rome criteria positive irritable bowel syndrome (IBS), called postinfection IBS (PI-IBS). The pooled prevalence of PI-IBS following AGE was 11.5%. PI-IBS is the best natural model that suggests that a subset of patients with IBS may have an organic basis. Several factors are associated with a greater risk of development of PI-IBS following AGE including female sex, younger age, smoking, severity of AGE, abdominal pain, bleeding per rectum, treatment with antibiotics, anxiety, depression, somatization, neuroticism, recent adverse life events, hypochondriasis, extroversion, negative illness beliefs, history of stress, sleep disturbance, and family history of functional gastrointestinal disorders (FGIDs), currently called disorder of gut-brain interaction. Most patients with PI-IBS present with either diarrhea-predominant IBS or the mixed subtype of IBS, and overlap with other FGIDs, such as functional dyspepsia is common. The drugs used to treat non-constipation IBS may also be useful in PI-IBS treatment. Since randomized controlled trials on the efficacy of drugs to treat PI-IBS are rare, more studies are needed on this issue.
在细菌、病毒或原生动物引起的急性肠胃炎(AGE)之后,一部分患者会出现新的罗马标准阳性的肠易激综合征(IBS),称为感染后肠易激综合征(PI-IBS)。AGE 后 PI-IBS 的总患病率为 11.5%。PI-IBS 是最好的自然模型,表明一部分 IBS 患者可能有器质性基础。许多因素与 AGE 后发生 PI-IBS 的风险增加有关,包括女性、年龄较小、吸烟、AGE 严重程度、腹痛、直肠出血、抗生素治疗、焦虑、抑郁、躯体化、神经质、近期不良生活事件、疑病症、外向、负面疾病信念、压力史、睡眠障碍和功能性胃肠道疾病(FGIDs)家族史,现称为肠-脑互动障碍。大多数 PI-IBS 患者表现为腹泻为主型 IBS 或 IBS 的混合亚型,与其他 FGIDs 重叠,如功能性消化不良很常见。用于治疗非便秘型 IBS 的药物在 PI-IBS 治疗中也可能有用。由于针对 PI-IBS 药物疗效的随机对照试验很少,因此需要对此问题进行更多研究。
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