title: Systematic review with meta-analysis: post-infectious irritable bowel syndrome after travellers' diarrhoea.
abstract: BACKGROUND
  Gastrointestinal infection is known as a risk factor for the development of the irritable bowel syndrome (post-infectious irritable bowel syndrome, PI-IBS). The incidence of PI-IBS ranges between 3% and over 30% of people after infectious gastroenteritis.
  
  
  OBJECTIVE
  To perform a meta-analysis pools and report data concerning the relative risk (RR) of PI-IBS after TD.
  
  
  METHODS
  Database search using Medline through PubMed, Scopus, EBM Reviews (Cochrane Database of Systematic Reviews) and PsycINFO was performed to identify relevant studies. Those that met the inclusion criteria were pooled. A random effects model (Mantel-Haenszel) was performed.
  
  
  RESULTS
  Six eligible studies were found. In three of six studies, the authors reported a statistically significant association of TD and PI-IBS. The pooled RR was 3.35 (95% CI: 2.22-5.05) with a significant overall effect (P < 0.00001). Overall PI-IBS incidence was 5.4% in TD subjects and 1.4% in healthy subjects. There was no significant heterogeneity within the pooled studies (I(2)  = 5%). Self-reported TD alone resulted in an over 1.5-fold RR for PI-IBS compared to laboratory-confirmed TD [RR 3.90 (95% CI: 2.35-6.49) vs. RR 2.42 (95% CI: 1.22-4.78)].
  
  
  CONCLUSIONS
  There is a strong association between travellers' diarrhoea and post-infectious irritable bowel syndrome. Self-reports of exposure seem to result in a higher post-infectious irritable bowel syndrome occurrence than laboratory-confirmed cases of travellers' diarrhoea, but further studies are needed to confirm this finding. Finally, potential influences of the selection of an appropriate study population on post-infectious irritable bowel syndrome epidemiology are discussed.
authors: Department of Internal Medicine VI: Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
authors: J
authors: J
authors: Schwille-Kiuntke
authors: N
authors: N
authors: Mazurak
authors: P
authors: P
authors: Enck
mesh_terms: D003967:Diarrhea / Q000150:complications*; D005756:Gastritis / Q000150:complications*; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014195:Travel