Irritable bowel syndrome in persons who acquired trichinellosis.
OBJECTIVE
The postinfectious irritable bowel syndrome (PI-IBS) frequently follows bacterial infections. Since people suffering from PI-IBS and Trichinella spiralis-infected mice develop similar findings, this animal model has been successfully used for PI-IBS studies; however, IBS has never been studied in humans after trichinellosis. The aim of this study was to evaluate the IBS symptoms in people who had acquired trichinellosis.


METHODS
A large outbreak of trichinellosis caused by Trichinella britovi occurred in Izmir, Turkey, in 2003-2004. The diagnosis of trichinellosis was confirmed by serology and muscle biopsy. After clinical and laboratory evaluations, 72 patients (38 women, 34 men, mean age 33.2 +/- 10.4 yr) with trichinellosis without preexisting IBS were enrolled in the study. Noninfected people (N=27) were used as control group. A questionnaire was developed to assess symptoms of IBS and alarm symptoms. The first interview was done face-to-face. After 2, 4, and 6 months of the first interview, the questionnaire was readministered to the patients without any information on the occurrence of a previous trichinellosis syndrome, while it was applied after a year only to the patients who had suffered IBS symptoms according to at least one of the previous interviews.


RESULTS
According to Rome II criteria, PI-IBS developed in 10 of 72 (13.9%) people with confirmed trichinellosis, who had no preexisting IBS. The rate of PI-IBS was 13.9% and 13.9% at the 4th and 6th months, respectively. The symptoms of PI-IBS persisted in five of them up to 1 yr. People without trichinellosis did not develop any IBS symptoms.


CONCLUSIONS
This is the first report of the development of PI-IBS after T. britovi. Consequently, IBS can be considered as a secondary syndrome induced by trichinellosis.
Soyturk
Mujde
M
Department of Internal Medicine, Division of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
Akpinar
Hale
H
Gurler
Oguz
O
Pozio
Edoardo
E
Sari
Ismail
I
Akar
Servet
S
Akarsu
Mesut
M
Birlik
Merih
M
Onen
Fatos
F
Akkoc
Nurullah
N
D000328:Adult; D000818:Animals; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000469:parasitology*; D008297:Male; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014235:Trichinellosis / Q000150:complications* / Q000453:epidemiology / Q000469:parasitology; D014421:Turkey / Q000453:epidemiology