J Neurogastroenterol Motil.  2025 Jan;31(1):110-118. 10.5056/jnm24018.

Incidence and Clinical Course of Post-infectious Irritable Bowel Syndrome in Patients Admitted to University Hospitals: 1-year Prospective Follow-up Study

• Lee JG
• Lee SP
• Jang HJ
• Kae SH
• Shin WG
• Seo SI
• Lim H
• Kang HS
• Soh JS
• Bang CS
• Yang YJ
• Baik GH
• Kim JB
• Kim YJ
• Oh CK
• HGSG

• KMID: 2564650
• DOI: http://doi.org/10.5056/jnm24018

Abstract

Background/Aims
Post-infectious irritable bowel syndrome (PI-IBS) is characterized by chronic gastrointestinal symptoms that arise following an episode of infectious enteritis. The incidence rates vary, ranging from 5% to 32% and the risk factors are not well known. We aim to investigate the incidence and risk factors of PI-IBS in enteritis patients admitted to university hospitals in Korea.
Methods
This multi-center prospective study was conducted in patients hospitalized for infectious enteritis. Each patient underwent 1 outpatient visit and 3 telephone surveys during the first year after discharge to determine if PI-IBS occurred within the follow-up period.
Results
In the 3-month survey, 7 out of 354 patients (2%) were diagnosed with PI-IBS, and after 1 year, only 1 patient met the criteria for IBS. No statistically significant difference was found between the PI-IBS group and the non-PI-IBS group in terms of age, sex, underlying diseases, medication history, gastrointestinal symptoms, enteritis location, causative strain, hospitalization and treatment periods, and laboratory findings. Female sex (P = 0.003), enteropathogenic Escherichia coli (EPEC) infection (P = 0.044), and a longer total treatment period (P = 0.018) were independent risk factors for diarrhea lasting ≥ 3 months after enteritis.
Conclusions
The incidence of PI-IBS in Korea was relatively low, and most cases improved over time. No risk factors associated with the development of PI-IBS were found. However, persistent diarrhea after enteritis was associated with female sex, EPEC infection, and severe or long-lasting enteritis. IBS symptoms may persist after severe enteritis but usually improve with time.

Keyword

Enteritis; Irritable bowel syndrome; Rome IV criteria