title: Postinfectious functional gastrointestinal disorders: a focus on epidemiology and research agendas.
abstract: Epidemiologic research is fundamental and complementary to our understanding of disease and development of primary, secondary, and tertiary interventions. To put the current evidence into context and identify gaps and research priorities in the areas of disease attribution, burden of disease, clinical characterization, and management of postinfectious functional gastrointestinal disorders (PI-FGDs), we took a multidisciplinary approach from the domains of infectious disease, gastroenterology, epidemiology, and public health. Our review of data from these disciplines found that, despite a complete understanding of pathoetiology, studies continue to accumulate and point toward evidence of a causal association for FGD. For some FGDs, Bradford Hill's criteria for causality yield more certainty than other criteria. In addition, the growing recognition of the impact of acute foodborne illness on economics and society is leading to exploration of the potential long-term health effects and disease burden of PI-FGDs, although a paucity of data exist in terms of pathogen-specific risk, disability duration, and relevant disability weights. Lastly, the understanding of PI-FGDs is changing the way research is approached and suggests a need for a more expansive exploration of biologic mechanisms and how FGDs are categorized. Areas of research priorities are catalogued in this paper and will hopefully provide inspiration for future studies and contributions to the field of gastroenterology.
authors: Dr. Deising is a Fellow in the Department of Gastroenterology at Walter Reed National Military Medical Center in Bethesda, Maryland. Dr. Gutierrez (Infectious Diseases), Dr. Porter (Epidemiology), and Dr. Riddle (Public Health) are Staff Scientists in the Enteric Diseases Department of Naval Medical Research Center in Silver Spring, Maryland.
authors: Adam
authors: A
authors: Deising
authors: Ramiro L
authors: RL
authors: Gutierrez
authors: Chad K
authors: CK
authors: Porter
authors: Mark S
authors: MS
authors: Riddle
keywords: Functional gastrointestinal disorder; causation; dyspepsia; irritable bowel syndrome; qualitative review
references: Am J Gastroenterol. 2001 Nov;96(11):3122-9
references: 11721759
references: Gastrointest Endosc. 2004 Jun;59(7):772-81
references: 15173788
references: Am J Gastroenterol. 2007 May;102(5):1064-9
references: 17313500
references: BMC Gastroenterol. 2012 May 28;12:55
references: 22639930
references: Epidemiol Infect. 2010 Nov;138(11):1650-6
references: 20223049
references: J Hosp Infect. 2011 Feb;77(2):172-3
references: 21190754
references: Dig Liver Dis. 2009 Dec;41(12):850-3
references: 19740713
references: Gastroenterology. 2005 Jul;129(1):98-104
references: 16012939
references: Tunis Med. 2012 Mar;90(3):205-13
references: 22481191
references: Neurogastroenterol Motil. 2003 Feb;15(1):79-86
references: 12588472
references: Am J Gastroenterol. 2006 Aug;101(8):1894-9; quiz 1942
references: 16928253
references: Aliment Pharmacol Ther. 2007 Aug 15;26(4):535-44
references: 17661757
references: J Epidemiol Community Health. 2010 May;64(5):387
references: 20445209
references: Clin Gastroenterol Hepatol. 2009 Jan;7(1):48-53
references: 18848909
references: BMJ. 1997 Mar 15;314(7083):779-82
references: 9080994
references: J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:94-101
references: 21443719
references: J Gastroenterol Hepatol. 2008 Nov;23(11):1689-94
references: 19120860
references: BMC Gastroenterol. 2008 Sep 23;8:43
references: 18808723
references: Hepatogastroenterology. 2012 Jan-Feb;59(113):67-72
references: 22024145
references: Am J Physiol Gastrointest Liver Physiol. 2012 May 15;302(10):G1075-84
references: 22403795
references: Health Policy Plan. 2003 Dec;18(4):351-6
references: 14654511
references: Acta Gastroenterol Belg. 2011 Sep;74(3):375-80
references: 22103040
references: J Gastroenterol Hepatol. 2010 May;25 Suppl 1:S138-43
references: 20586856
references: Gastroenterology. 2008 Sep;135(3):781-6
references: 18640117
references: Scand J Gastroenterol. 2005 Jan;40(1):112-4
references: 15841724
references: J Gastroenterol Hepatol. 2005 Mar;20(3):381-6
references: 15740480
references: Chin J Integr Med. 2011 Jun;17(6):410-3
references: 21660674
references: Prev Med. 2011 Oct;53(4-5):217-20
references: 21824490
references: Dig Dis Sci. 2008 Jan;53(1):271-6
references: 17549631
references: Gastroenterology. 2011 Nov;141(5):1792-801
references: 21820992
references: J Neurogastroenterol Motil. 2012 Apr;18(2):200-4
references: 22523730
references: Prev Med. 2011 Oct;53(4-5):232-4
references: 21983603
references: Am J Physiol Gastrointest Liver Physiol. 2011 Nov;301(5):G799-807
references: 21737778
references: Cochrane Database Syst Rev. 2011 Aug 10;(8):CD003460
references: 21833945
references: Gut. 2007 Aug;56(8):1066-71
references: 17324974
references: Aliment Pharmacol Ther. 2003 Jul 1;18(1):77-84
references: 12848628
references: Curr Treat Options Gastroenterol. 2007 Aug;10(4):259-72
references: 17761119
references: World J Gastroenterol. 2010 Aug 7;16(29):3680-6
references: 20677340
references: Clin Pediatr (Phila). 2007 Oct;46(8):683-8
references: 17554140
references: World J Gastroenterol. 2009 Apr 7;15(13):1548-53
references: 19340896
references: Med Decis Making. 2008 Jul-Aug;28(4):500-10
references: 18420835
references: Clin Ter. 2011;162(2):157-61
references: 21533323
references: Cytokine. 2012 Feb;57(2):201-9
references: 22178716
references: J Epidemiol Community Health. 2011 May;65(5):392-5
references: 20947872
references: J Clin Gastroenterol. 2009 Jul;43(6):534-40
references: 19262407
references: Gastroenterology. 2004 Jul;127(1):179-87
references: 15236184
references: Epidemiol Infect. 2007 Oct;135(7):1057-68
references: 17445316
references: Gut. 2002 Sep;51(3):410-3
references: 12171965
references: Am J Physiol Gastrointest Liver Physiol. 2009 Mar;296(3):G510-6
references: 19147801
references: Eur J Gastroenterol Hepatol. 2012 Jun;24(6):702-7
references: 22382707
references: Gastroenterology. 2011 Nov;141(5):1555-9
references: 21945058
references: Scand J Gastroenterol. 2009;44(10):1173-85
references: 19711225
references: Curr Gastroenterol Rep. 2007 Oct;9(5):378-84
references: 17991338
references: J Hepatol. 2005;42 Suppl(1):S100-7
references: 15777564
references: BMC Gastroenterol. 2009 Apr 21;9:27
references: 19383162
references: Neurogastroenterol Motil. 2011 Nov;23(11):e523-33
references: 21895877
references: J Neurogastroenterol Motil. 2011 Oct;17(4):349-59
references: 22148103
references: J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:88-93
references: 21443718
references: Syst Rev. 2012 Aug 28;1:39
references: 22929178
references: Z Gastroenterol. 2011 Aug;49(8):997-1003
references: 21811952
references: Gastroenterology. 2009 Feb;136(2):376-86
references: 19124023
references: J Gastroenterol Hepatol. 2010 Feb;25(2):244-51
references: 20074148
references: Aliment Pharmacol Ther. 2004 May 1;19(9):1025-31
references: 15113370
references: Am J Gastroenterol. 2012 Jun;107(6):891-9
references: 22525306
references: J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:110-5
references: 21443722
references: J Health Econ. 1997 Dec;16(6):685-702
references: 10176779
references: Emerg Infect Dis. 2011 Jan;17(1):7-15
references: 21192848
references: World J Gastroenterol. 2011 Sep 7;17(33):3761-75
references: 21987618
references: J Pediatr Gastroenterol Nutr. 2004 Jun;39 Suppl 2:S601-10
references: 15184759
references: Therap Adv Gastroenterol. 2012 Jul;5(4):261-8
references: 22778791
references: Nutrition. 2009 Jun;25(6):706-14
references: 19230613
references: Lancet. 2003 Aug 2;362(9381):383-91
references: 12907013
references: Dig Dis Sci. 2011 Jul;56(7):1962-6
references: 21222158
references: Ann Intern Med. 2000 Jul 18;133(2):136-47
references: 10896640
references: Gut Liver. 2011 Dec;5(4):472-7
references: 22195246
references: Proc Natl Acad Sci U S A. 2011 Mar 15;108 Suppl 1:4607-14
references: 20826446
references: Am J Gastroenterol. 2003 Jul;98(7):1578-83
references: 12873581
references: Am J Gastroenterol. 2009 Apr;104(4):1033-49; quiz 1050
references: 19277023
references: Curr Opin Infect Dis. 2011 Oct;24(5):503-8
references: 21844806
references: Aliment Pharmacol Ther. 2003 Mar 1;17(5):643-50
references: 12641512
references: Clin Gastroenterol Hepatol. 2007 Apr;5(4):457-60
references: 17289440
references: N Engl J Med. 2007 Oct 25;357(17):1731-43
references: 17960014
references: Am J Gastroenterol. 2010 Feb;105(2):435-41; quiz 442
references: 19861954
references: Am J Gastroenterol. 2012 Jul;107(7):981-9
references: 22508147
references: J Clin Gastroenterol. 2009 Mar;43(3):214-20
references: 19623100
references: Gastroenterology. 1997 Oct;113(4):1224-32
references: 9322517
references: Gut. 2010 May;59(5):605-11
references: 20427395
references: Am J Gastroenterol. 2003 Feb;98(2):327-31
references: 12591050
references: J Physiol. 2008 Sep 15;586(18):4517-30
references: 18653657
references: Gastroenterol Clin North Am. 2011 Mar;40(1):45-67
references: 21333900
references: Gastroenterology. 2006 Aug;131(2):445-50; quiz 660
references: 16890598
references: Am J Gastroenterol. 2009 Sep;104(9):2267-74
references: 19568228
references: Drugs Today (Barc). 2006 Jul;42 Suppl B:3-8
references: 16986065
references: Gastroenterology. 2010 Apr;138(4):1502-13
references: 20044998
references: Inflamm Bowel Dis. 2011 Aug;17(8):1714-8
references: 21744425
references: J Clin Gastroenterol. 2011 Aug;45 Suppl:S102-5
references: 21666422
references: Lancet. 1996 Jan 20;347(8995):150-3
references: 8544549
references: Neurogastroenterol Motil. 2006 Sep;18(9):839-43
references: 16918763
references: Prev Med. 2011 Oct;53(4-5):242-5
references: 21843547
references: Neurogastroenterol Motil. 2012 Jun;24(6):546-52, e252
references: 22356614
references: N Engl J Med. 2011 Jan 6;364(1):22-32
references: 21208106
references: Am J Gastroenterol. 2011 Jan;106(1):130-8
references: 20859264
references: Am J Trop Med Hyg. 2010 Feb;82(2):301-5
references: 20134008
references: Microbiology (Reading). 2010 Nov;156(Pt 11):3205-3215
references: 20705664
references: Clin Infect Dis. 2012 Mar 1;54(5):707-13
references: 22157322
references: World J Gastroenterol. 2009 Aug 7;15(29):3591-6
references: 19653335
references: J Neurogastroenterol Motil. 2010 Jan;16(1):30-4
references: 20535323
references: Yale J Biol Med. 1976 May;49(2):175-95
references: 782050
references: Rev Gastroenterol Disord. 2006 Spring;6(2):72-8
references: 16699476
references: J Gastroenterol. 2011 Feb;46(2):164-74
references: 20848144
references: Am J Gastroenterol. 2012 Aug;107(8):1248-55
references: 22584218
references: J Clin Gastroenterol. 2002 Jul;35(1):14-20
references: 12080220
references: Med J Aust. 1985 Apr 15;142(8):436-9
references: 3982345
references: Neurogastroenterol Motil. 2012 Jun;24(6):503-12
references: 22583600
references: Gut. 2013 Jul;62(7):985-94
references: 22684480
references: Clin Gastroenterol Hepatol. 2007 Apr;5(4):465-9
references: 17445753