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Disease
Symptom
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Pivot Concepts:
Gene/Protein
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Target Concepts:
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Query: UMLS:C0022104 (
irritable bowel syndrome
)
8,033
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The functional gastrointestinal disorders are defined by the Rome criteria as a heterogeneous group of symptom-based conditions that have no structural or biochemical explanation. However, this definition now seems outdated, because structural and molecular abnormalities have begun to be recognized in subsets of patients with the
irritable bowel syndrome
(
IBS
), the prototypic functional bowel disease. A complex classification system based arbitrarily on symptom criteria does not fit in with a number of emerging facts. For example, the symptom overlap of
IBS
with gastroesophageal reflux disease is not due to chance, and the emergence of post-infectious
IBS
, dyspepsia, or both after
Salmonella gastroenteritis
fits better with a 1-disease model. A new paradigm seems to be needed. All of these disorders may arise after infection or gut inflammation, but the phenotype depends on localized neuromuscular dysfunction in the predisposed human host (the "irritable gut").
...
PMID:A unifying hypothesis for the functional gastrointestinal disorders: really multiple diseases or one irritable gut? 1669 76
Objective:
Acute gastroenteritis (AGE) is a risk factor for post-infectious
irritable bowel syndrome
(PI-IBS). This systematic review evaluates the prevalence and risk-factors of PI-
IBS
after AGE by specific pathogens.
Materials and methods:
Medline (1966-2019) and Embase (1974-2019) were searched for studies evaluating PI-
IBS
minimum 3 months after AGE with
Campylobacter
spp.,
Salmonella
spp.,
Shigella
spp.,
Escherischia coli
,
Clostridium difficile
, norovirus, rotavirus,
Cryptosporidium
spp. or
Giardia intestinalis
using validated criteria for
IBS
. Pooled prevalence (PP), odds ratios (OR) and risk factors were determined for single pathogens, groups of bacteria, viruses and parasites, and overall for AGE caused by any pathogen. Random-effect models were used for meta-analyses.
Results:
A total of 34 articles were included. PP of PI-
IBS
after
Campylobacter
spp. was 12% (confidence interval 95% [CI]: 10-15%),
Salmonellosis
12% (CI: 9-15%), Shigellosis 11% (CI: 8-15%),
C. difficile
14% (CI: 4-29%) and
E. coli
spp. 12% (CI: 5-20%). OR of PI-
IBS
after salmonellosis was 5.5 (CI: 2.3-12.8) and after shigellosis 13.8 (CI: 4.2-45.4). Bacterial AGE overall showed OR 5.8 (CI: 4.0-8.3) and AGE caused by any pathogen OR 4.9 (CI: 3.9-6.1). Few studies exist on viral and parasitic gastroenteritis.
Conclusions:
Current literature show similar risks for bacterial pathogens. Studies are limited for viral and parasitic pathogens. The evaluated risk-factors for PI-
IBS
varied among the included studies and the existing evidence is insufficient to identify pathogen-specific risk factors.
...
PMID:Systematic review with meta-analyses: does the pathogen matter in post-infectious irritable bowel syndrome? 3111 63