Post-infectious irritable bowel syndrome in a paediatric population: first data in a Middle Eastern country.

BACKGROUND

Acute gastroenteritis (AGE) is the second most common cause of paediatric hospitalizations and mortality worldwide. The type of etiological agent determines its clinical severity. Interestingly, AGE has been shown as a risk factor for the development of post-infection irritable bowel syndrome (PI-IBS). In this study, we aimed to correlate the clinical severity of AGE for different infectious etiologies with the occurrence of PI-IBS in North Lebanese children and adolescents.

METHODS

A total of 219 patients admitted with gastrointestinal complaints, aged between four and 15 years, were enrolled in this study. For each patient, a stool sample was obtained for microbiological analysis. Data on demographic and socioeconomic characteristics, and clinical history were collected. AGE severity was evaluated using the Vesikari Clinical Severity Scoring System. The patients were then followed to assess the development of PI-IBS, using the Bristol stool form scale and the Rome IV diagnostic criteria.

RESULTS

Viral pathogens were the predominant etiological agents of AGE (26.9%), followed by parasites (8.2%), and Salmonella spp. (4.6%). Of all the pathogens identified in this study, rotavirus was the predominant infectious agent (25.1%) associated with severe AGE. Children with parasitic or bacterial AGE had significantly higher C-reactive protein (CRP) average levels (p = 0.009). Moreover, 29 patients (13.24%) met the Rome IV criteria for PI-IBS, with mixed bowel habits (IBS-M) (48.3%) as the most frequent subtype.

CONCLUSION

This study provided novel preliminary data on the development of PI-IBS in Lebanese children and adolescents. Further studies are needed to explore the pathogenesis of PI-IBS and possible prevention strategies.

CLINICAL TRIAL NUMBER

Not applicable.