[Postinfectious irritable bowel syndrome].
Postinfectious irritable bowel syndrome (IBS) is a subgroup of IBS. Patients with an episode of bacterial gastroenteritis may have a 12-fold increased risk of developing IBS symptoms within the same year. The IBS can be manifested in each of its clinical types, but the diarrhea-predominant form occurs most commonly. The primary pathophysiologic factor in developing IBS after enteral infection may be defects in enteric nervous system which can produce abnormality in visceral hypersensitivity and intestinal motility. These patients also display exaggerated increases in mucosal immunocompetent T lymphocytes and an abnormally high pro- versus anti-inflammatory cytokine ratio, providing evidence to the contribution of the immune system in the development of postinfectious IBS. Via bi-directional brain-gut interactions both peripheral and central events can play a role in the development of clinical symptoms. Stress is associated with significant worsening of the complaints in IBS and may also result in a shift in the host-gut microbial relationship. IBS itself may predispose patients to acute bacterial gastroenteritis because of the altered intestinal motility. It needs further clarifying the relationship between IBS and small intestinal bacterial overgrowth syndrome. Upon the data so far the altered intestinal flora in IBS would merely reflect developments due to altered motility and not a causal relationship. The treatment of postinfectious IBS does not differ principally from that of the idiopathic IBS. Antibiotics or probiotics may lead to temporary symptomatic improvement, but, given the lack of evidence based data, they cannot be advised for routine use so far.
Döbrönte
Zoltán
Z
Vas Megye és Szombathely Megyei Jogú Város Markusovszky Kórháza, Oktatókórház, Gasztroenterológiai és Belgyógyászati Osztály, Szombathely. dobronte.zoltan@markusovszky.hu
Lakner
Lilla
L
Sarang
Krisztina
K
D001424:Bacterial Infections / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D016207:Cytokines / Q000378:metabolism; D003967:Diarrhea / Q000382:microbiology; D005759:Gastroenteritis / Q000150:complications* / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology*; D013601:T-Lymphocytes / Q000276:immunology
D016207:Cytokines