What is the role of infection in the pathophysiology of irritable bowel syndrome (IBS)?

Updated: Dec 30, 2019
  • Author: Mohammad F El-Baba, MD; Chief Editor: Carmen Cuffari, MD  more...
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Some investigations found a correlation between the development of irritable bowel syndrome and a prior severe GI infection, especially in patients with higher scores for anxiety. [19] Symptoms compatible with irritable bowel syndrome affect 10-15% of adult patients after acute infectious gastroenteritis. Factors that increase risk to develop post infectious irritable bowel syndrome include severe and prolonged infection, female sex, younger age, antibiotic treatment for this infection, and concomitant presence of anxiety.

In one pediatric study, 36% of children with prior history of acute bacterial gastroenteritis developed abdominal pain symptoms that were consistent with functional GI disorders. Symptoms were compatible with irritable bowel syndrome in 87% and with dyspepsia in 24%. [20]

Studies have demonstrated low-grade lymphocytic infiltration in the intestinal mucosa, increased permeability, and increases in inflammatory components including EC and mast cells.

Some studies have shown that small intestinal bacterial overgrowth is common in subjects with irritable bowel syndrome. A double-blind placebo-controlled study by Pimentel et al (2003) showed that normalization of lactulose breath testing with neomycin correlated with symptom improvement in patients with irritable bowel syndrome. [21]

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