Phenotypic features of patients with post-infectious irritable bowel syndrome

BACKGROUND: Although there are many published data in the literature about irritable bowel syndrome (IBS), there are only few data on the long term evolution of patients with post infectious irritable bowel syndrome (PI-IBS) and associated conditions. AIMS: The purpose of our research was to study the evolution of PI-IBS patients in a single tertiary center over a period of four years. STUDY DESIGN: Our research was a longitudinal retrospective study. METHODS: We carried out this study based on the survey of the patients records. We recruited two groups of patients: patients with classical IBS and patients with PI-IBS. The IBS diagnosis was established using ROME III criteria, which were used at that time. We compared the two groups of patients by analyzing the demographic data, comorbidities, treatment that was prescribed, and evolution after treatment for a period of 48 month on average. RESULTS: From a total of 592 patients that were diagnosed with IBS between 2013–2016, we identified a subgroup of 64 patients with PI-IBS. These patients were also divided into two subgroups, depending on the main symptoms, 51 with PI-IBS – diarrhea and 13 of them with PI-IBS-constipation. IBS is the most commonly diagnosed among women, 45 patients were women and 15 were men. Regarding the frequency of occurrence of a certain subtype by gender, no significant differences were observed in both IBS and PI-IBS. We noticed a higher incidence of patients residents of an urban community in both groups. The main symptoms were: abdominal pain and bowel disorders (constipation, diarrhea). There was a significant difference between the two groups regarding the onset of the symptoms. From the total of 64 patients with PI-IBS, 88.3% presented a sudden onset of symptoms (mainly abdominal pain) unlike the other group where 81% of them presented a progressive onset, with an insidious progress and sporadic exacerbation. Most patients (65.63%) presented an improvement after the treatment, 25.56% oscillating periods but with a significant decrease of intensity of symptoms, and 7.8% did not show improvement after treatment. The most common associated diseases were depression and anxiety (34.37%). CONCLUSION: IBS is generally present in approximately 11% of the population, with PI-IBS patients accounting for approximately 10% of them. Female gender is more common in both IBS and PI-IBS. Patients with PI-IBS are a burden in the health system in terms of the important economic resources used for diagnosis and treatment.