[kc99]

Just a question that occurred to me: Does anyone know if there is a particular time window during which IBS symptom onset must occur in order for it to be characterized as post-infectious IBS (as opposed to IBS of a different/unknown cause)? The majority of the descriptions that I've read concern symptoms that immediately follow recovery from the infectious episode, although I've also read that the symptoms can begin up to 4 months later. With the increased research going into this subtype, I've often thought back to a couple of gastroenteritis episodes that I had during a study abroad semester in Mexico, but since my IBS-related pain did not begin until a year later, I've not adopted the "post-infectious" label. And, in any case, even if it were plausibly post-infectious, that classification may not even matter, because it's not clear that it would make any difference in the treatment approach.

 

[DAD]

kc99 -You might try the site listed below to find information you are looking for . . . you will have to log in for a free account to the information, but I have not been there. This site was forwarded to me by another.Postinfectious Irritable Bowel Syndrome -- A Real and Distinct Entityhttp://redirectingat.com/?id=1112X506838&a...rticle%2F562539Toward a Positive and Comprehensive Diagnosis of Irritable Bowel SyndromeDAD

 

[kc99]

Thanks DAD, I'll give it a look!

 

[Kathleen M.]

Usually when I see the studies that looked to see if IBS was more common after a GI infection they compared people 1 year out from the infection diagnosis. Now some is that anyone can have a few weeks of a dodgy colon after a GI infection, so you rule out all those that will get better on their own in a short period of time.But I don't know how long it can take to show up after the GI infection. Usually the most common description is starting up shortly afterward, not perfect for a year and then starting up.Although I do suspect there may be some damage that doesn't show up until something else (like physical or mental stress) triggers the symptoms.

 

[onyx]

I've wondered about this too. I had a bad GI infection picked up from overseas travel, that lasted for like two months. Then I was ok for about a year and a half after that, then IBS kicked in. I sort of figured the two are probably not directly related however as Kathleen suspects perhaps that bad exeperience weakened me, made me predisposed to get it later.

 

[Slade]

Mine started some 4-6 months after two bouts of gastroenteritis (now I don't remember the exact time). The two were approximately half a year apart and IBS struck several months after the second. First I thought it was another fulminant GI infection but it wasn't - it was here to stay...

 

[kc99]

Interesting...maybe there will be more research into this in the future. It would become most relevant if the treatment options started to diverge for IBS that was assumed to either be of infectious origin or not. But then again, if things got to that point, then perhaps treatment wouldn't rely on patients' memories of past illnesses but rather on some blood test for the relevant biomarkers.

 

[eric]

One of the leading experts on Post Infectious IBS is DR Spiller. You might searchh pubmed for his work.There is also this videoIn some people with IBS a subtle inflammation persists for some time after recovery from an initial infection and obvious inflammation. This can cause increased sensation in the intestines and changes in gut motility consistent with symptoms of IBS.http://www.aboutibs.org/site/learning-cent...er/inflammation

 

[S_LIne]

I think mine is post infectious my doctor hasn't a clue. He told me I don't have it and I just have "one of those stomachs" I got really sick at the end of January and really started noticing something was up in the beginning of May

 

[eric]

More than 2,300 people in Walkerton, Ontario developed GI infections from drinking contaminated water in the year 2000. Of these, more than 1 in 3 (36%) developed IBS.When IBS occurs after a sudden bout of infection in the stomach and intestines it is known as post-infectious (PI) IBS. Risk factors noted in the past for developing PI-IBS include the severity of the initial illness; host factors at the time of infection; and the harmfulness of the infecting organismIn a study to be published in the March issue of the journal Gastroenterology, a group of investigators from Canada looked at whether there might be a genetic difference that could make some of the people in Walkerton more susceptible to developing IBS. They studied data from infected individuals, comparing 228 who reported PI-IBS with 581 who did not develop PI-IBS.The researchers in this study found variations in certain genes that might increase the risk of developing PI-IBS.Source: Vallini A-C, et al. Genetic risk factors for post-infectious irritable bowel syndrome following a waterborne outbreak of gastroenteritis. Gastroenterology. Article in Press. 2010.http://www.iamibs.org/Dig Liver Dis. 2009 Dec;41(12):844-9. Epub 2009 Aug 28.Infection, inflammation, and the irritable bowel syndrome.Spiller R, Garsed K.Nottingham Digestive Diseases Centre Biomedical Research Unit, University Hospital, Nottingham, United Kingdom. [email protected] infection is ubiquitous worldwide though the pattern of infection varies widely. Poor hygiene and lack of piped water is associated with a high incidence of childhood infection, both viral and bacterial. However in developed countries bacterial infection is commoner in young adults. Studies of bacterial infections in developed countries suggest 75% of adults fully recover, however around 25% have long lasting changes in bowel habit and a smaller number develop the irritable bowel syndrome (IBS). Whether the incidence is similar in developing countries is unknown. Post-infective IBS (PI-IBS) shares many features with unselected IBS but by having a defined onset allows better definition of risk factors. These are in order of importance: severity of initial illness, smoking, female gender and adverse psychological factors. Symptoms may last many years for reasons which are unclear. They are likely to include genetic factors controlling the immune response, alterations in serotonin signaling, low grade mucosal inflammation maintained by psychological stressors and alterations in gut microbiota. As yet there are no proven specific treatments, though 5HT(3) receptor antagonists, anti-inflammatory agents and probiotics are all logical treatments which should be examined in large well-designed randomised placebo controlled trials.PMID: 19716778 [PubMed - indexed for MEDLINE]

 

[Slade]

Could be that some IBS cases present with some degree of gut inflammation that is not detectable with blood tests or even colonoscopy. With start of my symptoms 2 years ago I got constant subfebrile temperature 37.1-37.5 that won't go away. All my life I've got temperature 36-36.6 not higher... This is not normal for me.One last check I'd like to do is to try with some SSRI or SNRI antidepresants to see if the temperature is not because of a psychic problem. The above comes from a recent observation during a cold (without fever). I was taking some combined drug with Paracetamol, vit C and Chlorpheniramine (antihistamine that also has weak SNRI antidepresant action) for a week and more than 10 days afterwards my temperature was completely normal (36). First I suspected the Paracetamol but it is a short acting drug and couldn't have lowered my temp for such a long period.P.S. Sorry for the off-topic

 

[eric]

Genetic Risk Factors for Post-Infectious Irritable Bowel Syndrome Following a Waterborne Outbreak of Gastroenteritis"We compared data from Walkerton residents who developed gastroenteritis and reported PI-IBS 2-3 years after the outbreak "http://www.gastrojournal.org/article/S0016...2246-X/abstractThe above was a viral outbreak. Howecver they also know it can be a bacterial enteritist as well.In some IBSers a "macroscopic inflammation" persists of specific cells after the intial infection. Stress can also reactivate or cause certain inflammation of specific cells.Inflammation cannot be a biological marker in IBS, because it does not always cause pain. Everyone with celiac sprue have inflammation, but not all of them have pain for example.

 

[kc99]

This is all really interesting stuff. Thanks for your replies. S LIne: I hope you can find a doctor who can help you. I would be really frustrated if someone told me I had "one of those stomachs." Slade: I have absolutely no medical background whatsoever, but a persistently elevated temperature does sound like something that you might want to get checked out (or maybe you have already). It's interesting to hear about your reactions to those medications. I tend to wonder if the antihistamine component may have been relevant as well, but then again, I have no pharmaceutical background either.I do wonder what's going to happen with this current line of research on inflammation, and particularly if one day it will start to lead to new treatments. But it still seems to be at an early stage, so I guess all one can do is wait...

 

[Borrellifan]

I read that Walkerton case study. Quite interesting.Does anyone know if Lyme Disease could possibly cause IBS? The only thing I can think of that happened to me releatively near to my IBS onset was Lyme Disease. It was probably a year or two after the Lyme that I started getting the IBS symptoms and the Lyme by no means caused any IBS symptoms when I had it.

 

[Sarmiento80]

I have post infectious IBS too. I try to treat it with anti-inflammtories and probiotics, but no change after 10 years with this. If people with PI-IBS have genetic similarities, that would be very interesting.

 

[Slade]

..Slade: I have absolutely no medical background whatsoever, but a persistently elevated temperature does sound like something that you might want to get checked out (or maybe you have already). It's interesting to hear about your reactions to those medications. I tend to wonder if the antihistamine component may have been relevant as well, but then again, I have no pharmaceutical background either....

I've already checked almost everything: sinuses, throat, lungs, liver, gallblader, kidneys & urinary, bloodwork + inflamation markers, parasites, bacteria (even chlamidia) - nothing that could cause this temperature, no obvious inflamation whatsoever.On the other hand the imbalance and dysregulation of certain neurotransmiters such as serotonin could definitely affect body temperature as well as causing certain psycho conditions (namely anxiety).P.S. Some recent publications claim that "normal" body temperature varies between 36.6-37.3 and some even claim that 38 is still "normal" and "healthy" temp not fever

 

[Kathleen M.]

The idea that all people are 98.6 (37) all the time and anything above or below is a sign of disease is wrong.It is a range and 98.6 is just the average number, not the only correct number.It isn't new that anything under 100 (38) is not a fever. It was that way when I was a kid.

 

[rosesquiril]

i got diagnosed with pi ibs nearly a year ago. but i got it after being in hospital with peritonitis. most information on the net does not seem to apply to me coz i didn't get i from food poisoning. I'm going through a pretty rough time at the moment with it. I'm living of meal replacement shakes coz i can't seem to digest or keep food down that is hard to digest and I'm in pain nearly all the time with stomach spasms and bowel cramps which take amitriptyline for. still struggling to understand why I'm like this