| Abstract: |
This article on postinfectious irritable bowel syndrome (PI-IBS) is from a special supplement issue of Practical Gastroenterology on the topic of IBS. The supplement reports on the proceedings of a meeting in September 2005 of a group of gastroenterologists who gathered to develop a shared understanding of the data regarding the role of intestinal bacteria in IBS. IBS is characterized by bloating, abdominal pain, flatulence, and altered bowel function, including diarrhea and constipation. In this article, the author focuses on the clinical aspects, pathophysiology, and treatment of PI-IBS, which is defined as new onset of IBS after an acute episode of infectious diarrhea. The author hypothesizes that chronic mucosal inflammation, immunologic changes, and biochemical alterations triggered by microbial infection may be involved in mechanisms leading to persistent intestinal symptoms. The differential diagnosis of PI-IBS involves ruling out other conditions that may cause prolonged diarrhea, including persistent enteric infection, co-infection, and malabsorption or food intolerance. Treatment often focuses on symptom relief, but the prevention and early treatment of acute bacterial illness with antimicrobials such as rifaximin may be important for reducing the risk of PI-IBS development, particularly in international travelers. 4 tables. 39 references. |