학술논문

Post-Infectious Irritable Bowel Syndrome
Document Type
Review Paper
Source
Current Gastroenterology Reports. 19(11)
Subject
Irritable bowel syndrome
Diarrhea
Gastroenteritis
Pathophysiology
Inflammation
Language
English
ISSN
1522-8037
1534-312X
Abstract
Purpose of Review: Post-infectious irritable bowel syndrome (PI-IBS) is characterized by persistent abdominal pain and diarrhea, typically following an episode of infectious gastroenteritis. The mechanisms that underlie IBS-D remain elusive, but PI-IBS provides a mechanistic model of this disorder. This review provides an up-to-date appraisal of the pathophysiology, clinical features, and management approaches for PI-IBS.Recent Findings: Disordered immune reactions and release of cytokines with resultant gut inflammation and dysfunction appear to be key features of PI-IBS. Disordered brain-gut-microbiota interactions, type of infecting agent, and host-genetic susceptibility are risk factors but also are reasons for the varying spectrum of clinical severity. Although prognosis is generally good, symptoms and inflammation may persist for a long time. Symptomatic relief with antidiarrheals, antispasmodics, 5HT3 antagonists, mesalamine, probiotics, and low-dose antidepressants remain the primary approaches, but in some difficult cases, a combination of drugs that target the pathophysiology may be helpful.Summary: PI-IBS has many overlapping features with IBS-D and shares similar pathophysiology and management approaches.