title: Postinfectious irritable bowel syndrome: follow-up of a patient cohort of confirmed cases of bacterial infection with Salmonella or Campylobacter.
abstract: BACKGROUND
  Gastrointestinal infections have been proposed to predict subsequent irritable bowel syndrome (IBS) but large-scale infectious events are rare and long-term data are missing.
  
  
  METHODS
  We identified 576 individuals with a Salmonella or Campylobacter infection between 2000 and 2009 that were followed by a short postal questionnaire asking for the presence of current symptoms in 2010. In case of agreement (n = 90), an extended postinfectious (PI)-IBS questionnaire was mailed including the Hospital Anxiety Depression Scale and the Patient Health Questionnaire.
  
  
  RESULTS
  A total of 189 patients reported back (36%); 98 had a Salmonella and 91 had a Campylobacter infection, of which 56 reported persistent symptoms (9.7% of the initial sample). Fifty-one patients returned the PI-IBS questionnaire. Of 48 patients with complete data, 15 reported no or mild symptoms of abdominal pain or discomfort while 17 had moderate and 16 severe symptoms. Twenty-two met Rome IBS criteria, 14 (29%) reported GI symptoms before the infection. Patients with moderate and/or severe PI-IBS symptoms were significantly more often females, were more often infected by Salmonella than by Campylobacter, had more severe symptoms during the initial infection, and had more often GI symptoms prior to the infection. They reported higher anxiety, depression, and somatisation scores, but were not different with respect to acute stool habits.
  
  
  CONCLUSIONS
  Nearly 10% of patients with an intestinal bacterial infection report postinfectious symptoms up to 10 years after the infectious event. They represent a clinically important population with high psychiatric comorbidity and somatic symptom burden.
authors: Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany.
authors: J
authors: J
authors: Schwille-Kiuntke
authors: P
authors: P
authors: Enck
authors: C
authors: C
authors: Zendler
authors: M
authors: M
authors: Krieg
authors: A V
authors: AV
authors: Polster
authors: S
authors: S
authors: Klosterhalfen
authors: I B
authors: IB
authors: Autenrieth
authors: S
authors: S
authors: Zipfel
authors: J-S
authors: JS
authors: Frick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D002167:Campylobacter / Q000472:pathogenicity; D002169:Campylobacter Infections / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000209:etiology* / Q000382:microbiology* / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012475:Salmonella / Q000472:pathogenicity; D012480:Salmonella Infections / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D013001:Somatoform Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult