scholarly journals Irritable bowel syndrome after Clostridium difficile infection

2019 ◽  
Author(s):  
Teodora Iacob ◽  
Mihaela Sorina Lupșe ◽  
Dan Lucian Dumitrașcu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Severe Form ◽  
Control Group ◽  
Tertiary Center ◽  
Rome Iii ◽  
Stool Form ◽  
Irritable Bowel ◽  
Gastroenteritis Episode

Abstract Background and Aim Post-Infectious Irritable Bowel Syndrome (PI-IBS) is a common complication of Clostridium difficile infection (CDI). The objectives of this study were to asses the risk of PI-IBS following a CDI. We also evaluated if there is a correlation between the onset of PI-IBS and the severity of CDI. Methods The study group consisted of 69 patients consecutively admitted in a tertiary center with an acute gastroenteritis episode, suspected of having a Clostridium difficile infection. PCR for CDI from feces were performed to assess the infection. The subjects were divided into two groups. A group consisted of patients with CDI and the other group where the CDI was ruled out. The patients were evaluated for PI-IBS 6 months after the episode of CDI by Rome III IBS diagnostic questionnaire and the Bristol Stool Form Scale. Severity of CDI was stratified according to the need for hospitalization or not. The questionnaires were paper printed and directly filled in by the subjects. Results The response rate to the questionnaire was 100%. During the course of this study 31 patients died. Out of 38 patients, 37% (14 patients) were diagnosed with CDI. After CDI, 57% (8 patients) developed PI-IBS and 43% (6 patients) where without PI-IBS with a relative risk (RR) of 2.29 (95 % confidence interval CI 0.99 – 5.23), p=0.04. In the group of patients with a severe form of CDI, 90% (9 patients) developed PI-IBS with a RR of 2.72 (95% CI 0.80 – 9.24), p=0.04, compared to the group of patients with light and moderate forms CDI. Conclusion Our study shows that, 6 months after CDI, PI-IBS develops in 57% patients, higher than in the control group where CDI was ruled out by PCR (43%), statitstically significant (p=0.04). The severity of CDI was a risk factor for PI-IBS, 90% of patients with severe forms of CDI developed PI-IBS.

Irritable bowel syndrome after Clostridioides difficile infection

2020 ◽  
Author(s):  
Teodora Iacob ◽  
Mihaela Sorina Lupșe ◽  
Dan Lucian Dumitrașcu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Severe Form ◽  
Control Group ◽  
Reactive Protein ◽  
Clostridioides Difficile ◽  
Tertiary Center ◽  
Clostridioides Difficile Infection ◽  
Rome Iii ◽  
Stool Form ◽  
Irritable Bowel

Abstract Background Post-Infectious Irritable Bowel Syndrome (PI-IBS) is a common complication of Clostridioides difficile infection (CDI). The objectives of this study were to asses the risk of PI-IBS following a CDI. We also evaluated if there is a correlation between the onset of PI-IBS and the severity of CDI.Methods The study group consisted of 69 patients consecutively admitted in a tertiary center with an acute gastroenteritis episode, suspected of having a Clostridioides difficile infection. PCR for CDI from feces were performed to assess the infection. The subjects were divided into two groups. A group consisted of patients with CDI and the other group where the CDI was ruled out. The patients were evaluated for PI-IBS 6 months after the episode of CDI by Rome III IBS diagnostic questionnaire and the Bristol Stool Form Scale. In these patients CDI recurrence was ruled out by PCR; patients were retested. Severity of CDI was stratified according to the need for hospitalization or not. Other evaluated parameters for severity at patients were the level of serum creatinin, C-reactive protein (CRP) and white blood cell count (WBC). The questionnaires were paper printed and directly filled in by the subjects.Results The response rate to the questionnaire was 100%. During the course of this study 31 patients died. Out of 38 patients, 37% (14 patients) were diagnosed with CDI. After CDI, 57% (8 patients) developed PI-IBS and 43% (6 patients) where without PI-IBS with a relative risk (RR) of 2.29 (95 % confidence interval CI 0.99 – 5.23), p=0.04. In the group of patients with a severe form of CDI, 90% (9 patients) developed PI-IBS with a RR of 2.72 (95% CI 0.80 – 9.24), p=0.04, compared to the group of patients with light and moderate forms CDI.Conclusion Our study shows that, 6 months after CDI, PI-IBS develops in 57% patients, higher than in the control group where CDI was ruled out by PCR (43%), statitstically significant (p=0.04). The severity of CDI was a risk factor for PI-IBS, 90% of patients with severe forms of CDI developed PI-IBS.

scholarly journals Four years Follow-up of Patients with Irritable Bowel Syndrome

2015 ◽  
Vol 53 (1) ◽  
pp. 65-74
Author(s):  
F. Rusu ◽  
Dan L. Dumitraşcu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Combined Therapy ◽  
Hemorrhoidal Disease ◽  
Associated Diseases ◽  
Tertiary Center ◽  
Rome Iii ◽  
Bowel Disorders ◽  
Irritable Bowel

Abstract There is little data on the long term evolution of patients with irritable bowel syndrome (IBS) and of associated conditions. We therefore studied the evolution of IBS patients in a single tertiary center during a long interval of time. Methods. We carried out a retrospective study based on the survey of patients records. We analyzed the records of symptoms, therapy, associated diseases, as consigned at follow-up visits for an interval of 4 years in average (2008-2011). Results. A cohort of 114 patients with IBS diagnosed based on Rome III criteria were included (29 men and 85 women), age 19-85 years (mean age: 43.45 years). Urban patients were predominant. The main three symptoms were: abdominal pain, bowel disorders (constipation, diarrhea) and bloating. IBS - constipation (IBS - C) is associated with a favorable course of symptoms (increasing the number of stools, decrease intensity of abdominal pain and bloating) after treatment and IBS - diarrhea (IBS - D) is associated with variable symptoms after treatment (p = 0.031). Using trimebutin or mebeverin in association with other drugs for one month correlates with a favorable evolution of symptoms after treatment and monotherapy is associated with fluctuating symptoms ( p< 0.001). Favorable symptoms are associated with the use of probiotics in combination, but not in monotherapy (p< 0.001). Favorable evolution of symptoms is also associated with the use of anxiolytics in combination. Persistence of symptoms after treatment was correlated with the presence or absence of depression. The absence of depression was correlated with a favorable evolution of symptoms (p = 0.005). IBS-C is associated at limit (marginal significance) with hemorrhoidal disease (p = 0.56). 33 patients (29%) - received monotherapy (trimebutin or mebeverin or probiotics); 81 patients (71%) - received combined therapy: (trimebutin or mebeverin or probiotics) + anxiolytics or proton pump inhibitors (PPI) or nonsteroidal anti-inflammatory (NSAI) or spasmolitics. The most common associated diseases observed in patients with IBS were: depression (27.19%), dyslipidemia (25.43%), hemorrhoidal disease (22.80%) and fibromyalgia (21%). Conclusions. The highest response rate was obtained with trimebutin or mebeverin + anxiolitics + probiotics. The most frequent disease associated with IBS was depression. Other diseases with a high incidence: dyslipidemia, hemorrhoidal disease and fibromyalgia. Further studies are needed to analyze the link between IBS and some associated diseases.

scholarly journals Lack of Association Found betweenHelicobacter pyloriInfection and Diarrhea-Predominant Irritable Bowel Syndrome: A Multicenter Retrospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Feng Xiong ◽  
Man Xiong ◽  
Zonghui Ma ◽  
Senxiong Huang ◽  
Aimin Li ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Retrospective Study ◽  
Control Group ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Rome Iii ◽  
H Pylori ◽  
Irritable Bowel

Aims. The association betweenHelicobacter pylori(H. pylori) infection and diarrhea-predominant irritable bowel syndrome (IBS-D) is still controversial. Here we performed a retrospective study to explore this issue.Methods. A total of 502 inpatients with Rome III confirmed IBS-D and knownH. pyloristatus from 8 hospitals were enrolled.H. pylori-positive patients, hospitalized in the recent year, were followed up to evaluate the effects ofH. pylorieradication on IBS-D clinical course.Results. Of the 502 IBS-D patients, 206 wereH. pylori-positive, with an infection rate that has no significant difference with that of the general population in Guangdong province (p=0.348). For patients followed up, no significant differences were noted as to overall symptoms (p=0.562), abdominal pain/discomfort (p=0.777), bloating (p=0.736), stool frequency (p=0.835), or stool characteristics (p=0.928) between theH. pylori-eradicated group and the control group. The results were the same in long-term follow-up patients except the improvement of bloating, which showed that the bloating score in theH. pylori-eradicated group was significantly lower (p=0.047).Conclusions. No significant correlation betweenH. pyloriinfection and IBS-D was noted. Overall, IBS-D patients may not benefit fromH. pylorieradication.

scholarly journals Patterns of alternation in irritable bowel syndrome

2016 ◽  
Vol 89 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Alexandra Chira ◽  
Mihaela Filip ◽  
Dan Lucian Dumitraşcu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Functional Gastrointestinal Disorders ◽  
Structured Interview ◽  
Pharmacological Therapy ◽  
Gastrointestinal Disorders ◽  
Rome Iii Criteria ◽  
Rome Iii ◽  
Stool Form ◽  
Irritable Bowel ◽  
Over Time

Background and aims. Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, having its subtypes related to the predominant bowel pattern: IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), mixed IBS (IBS-M) or alternating IBS (IBS-A). Some patients alternate between subtypes (IBS-A). We looked for the prevalence of alternation between subtypes in patients with IBS. We also analyzed changes in pharmacological therapy specifically addressed to IBS.Methods. We performed a retrospective observational study that included 60 patients diagnosed with IBS according to Rome III criteria. Patients were asked using a detailed structured interview about their stool form changes regarding previous six months. Alternators were defined as patients that changed IBS subtype over time (previous six months).Results. Out of the 60 patients diagnosed with IBS, 18 patients (30%) were alternators. Of these, 8 patients (44%) changed twice the subtype. Two patients (66.66%) of the IBS-M subgroup shifted between subtypes. Eight patients (44.44%) changed medication over the six months. Four patients (22.2%) of the alternators were on double association of therapy (antispasmodics) addressed to IBS. Four patients (22.22%) discontinued medication.Conclusions. Patients with IBS often change between subtypes even within six months. Alternators in our pilot study represented 30% of IBS patients. IBS-M seems to be the least stable phenotype. The rarest change is the shift between IBS-C and IBS-D. Alternators also often change their pharmacological treatment (antispasmodics).

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