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Travelers' Diarrhoea Can Trigger Irritable Bowel: Presented at IDSA

By M.M. Pennell

SAN DIEGO, CA -- October 22, 2003 -- About 10% of people who report cases of travelers' diarrhoea are at risk for developing chronic gastrointestinal disorders, including irritable bowel syndrome (IBS).

This news comes as a result of a study presented October 11^th at the 41^st Annual Meeting of the Infectious Diseases Society of America.

Lead investigator, Pablo Okhuysen, MD, associate professor of medicine, Division of Infectious Diseases, University of Texas Health Sciences Center, Houston, United States, prospectively followed 146 students who traveled to Mexico. Said Dr. Okhuysen, "Having diarrhoea while they were in Mexico -- and having more than one episode while traveling -- correlated with the likelihood of developing IBS. This confirms that there is probably a relationship between infectious gastroenteritis and IBS."

Dr. Okhuysen said that many IBS patients report onset of chronic symptoms after an initial attack of gastroenteritis. Published studies suggest that 7% to 33% of patients with bacterial gastroenteritis develop post-infection IBS.

Dr. Okhuysen and colleagues recruited 146 students who were followed prospectively for 4 weeks after arrival in Mexico. Students who developed diarrhoea were assessed for the presence of enteric pathogens. Assessment of chronic gastrointestinal symptoms was performed by questionnaire, which was mailed to the students 6 months after their return to the United States. Symptoms were evaluated according to the Rome II criteria to determine the presence of post-infection IBS.

Sixty-two students developed diarrhoea while traveling in Mexico, and a total of 98 students completed the 6-month follow-up, Dr. Okhuysen said.

Before travel, only 1 student met the criteria for IBS, but, after travel, seven students met IBS criteria, said Dr. Okhuysen. Additionally, at the 6-month follow-up 17 students reported chronic abdominal pain compared to five students before the trip, and 17 reported chronic diarrhoea, defined as diarrhea lasting 2 weeks or longer, while one student reported chronic diarrhoea before traveling to Mexico, he said.

All students who reported post-travel IBS experienced diarrhoea while in Mexico, while none of the students who were asymptomatic while in Mexico met the definition of IBS 6 months after travel. Dr. Okhuysen said the risk of post-travel IBS or post-travel gastrointestinal symptoms correlated with the severity of traveler's diarrhoea while in Mexico. Typically students who reported chronic gastrointestinal complaints experienced at least two episodes of diarrhoea while traveling, Dr. Okhuysen noted.


[Study Title: Frequency and Characteristics of Post Infectious Irritable Bowel Syndrome in Travelers to Mexico: Abstract 876]

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