title: Post-traveler's diarrhea irritable bowel syndrome: a prospective study.
abstract: OBJECTIVE
  Anecdotal evidence suggests that irritable bowel syndrome (IBS) can develop after an episode of traveler's diarrhea (TD). This observation supports a contemporary paradigm proposed for the etiology of IBS and may have important implications for public health strategies aimed at preventing TD. This study aimed to determine the incidence of IBS in people experiencing TD.
  
  
  METHODS
  A total of 109 healthy adults traveling outside of Canada or the United States were identified and enrolled in a prospective, cohort field study. GI symptoms before and after travel were assessed using the Rome I criteria. Travel diaries and questionnaires were used to assess for TD.
  
  
  RESULTS
  The incidence of TD in the study cohort was 44%. Among those experiencing TD, the incidence of IBS was 4.2%. In those not experiencing TD, the incidence of IBS post-travel was 1.6% (relative risk = 2.5, 95% CI = 0.2-27.2, p = 0.41, ns). There was no significant difference in the incidence of IBS between the exposed and nonexposed groups.
  
  
  CONCLUSIONS
  This study does not support a large association between TD and an increased risk of developing IBS. A small increase in relative risk may have been undetected because of the size of the study.
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, University of Manitoba, Manitoba, Winnipeg, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ilnyckyj
authors.forename: Brinda
authors.initials: B
authors.lastname: Balachandra
authors.forename: Lawrence
authors.initials: L
authors.lastname: Elliott
authors.forename: Shurjeel
authors.initials: S
authors.lastname: Choudhri
authors.forename: Donald R
authors.initials: DR
authors.lastname: Duerksen
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D003109:Colonic Diseases, Functional / Q000453:epidemiology* / Q000209:etiology*; D003906:Developing Countries; D003967:Diarrhea / Q000150:complications* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014195:Travel