1. Salmonella Gastroenteritis During Childhood Is a Risk Factor for Irritable Bowel Syndrome in Adulthood
- Author
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Roberto De Giorgio, Elisa Fogacci, Vincenzo Stanghellini, Cesare Cremon, Roberto Corinaldesi, Rosanna Cogliandro, Lara Bellacosa, Francesca Pallotti, Giovanni Barbara, Giovanni Di Nardo, Alexandro Paccapelo, Antonio Maria Morselli-Labate, Cremon, Cesare, Stanghellini, Vincenzo, Pallotti, Francesca, Fogacci, Elisa, Bellacosa, Lara, Morselli-Labate, Antonio M, Paccapelo, Alexandro, Di Nardo, Giovanni, Cogliandro, Rosanna F, De Giorgio, Roberto, Corinaldesi, Roberto, and Barbara, Giovanni
- Subjects
Male ,Pediatrics ,Epidemiology ,Cohort Studies ,Irritable Bowel Syndrome ,irritable bowel sindrome ,Risk Factors ,Retrospective Studie ,Surveys and Questionnaires ,Prevalence ,Surveys and Questionnaire ,Age Factor ,Prospective Studies ,Child ,Salmonella Infection ,Irritable bowel syndrome ,Outcome ,Gastroenteriti ,Age Factors ,Gastroenterology ,Middle Aged ,Gastroenteritis ,Food Poisoning ,Italy ,Child, Preschool ,Salmonella Infections ,Cohort ,Female ,Case-Control Studie ,Human ,Cohort study ,Adult ,medicine.medical_specialty ,Salmonella enteritidis ,Bacteria ,Case-Control Studies ,Preschool ,Humans ,Retrospective Studies ,NO ,children ,medicine ,gastroenteritis ,Risk factor ,Hepatology ,business.industry ,Risk Factor ,Outbreak ,Odds ratio ,medicine.disease ,Prospective Studie ,Cohort Studie ,business - Abstract
Background & Aims Acute infectious gastroenteritis increases the risk for irritable bowel syndrome (IBS) and functional dyspepsia (FD). Children are particularly vulnerable to gastroenteritis because of the immaturity of their intestinal barrier, enteric nervous system, and immune response to pathogens. We investigated whether acute gastroenteritis in early life increases the risk of IBS and FD throughout adulthood. Methods In 1994, we identified and monitored a single culture-proven foodborne Salmonella enteritidis outbreak that involved 1811 patients (mostly pediatric) in Bologna, Italy. Clinical data were collected and a prospective, controlled, cohort study was designed. Long-term effects were assessed by mailing a questionnaire to 757 subjects 16 years after the outbreak (when all of the children were adults). We randomly selected a cohort of 250 adults exposed to Salmonella as children, all 127 individuals exposed as adults, and a cohort of nonexposed participants matched for number, age, sex, and area of residence (controls). Results Among 198 exposed participants, 64 reported FD (32.3%), compared with 51 of 188 controls (27.1%; P = .268). Among 204 exposed participants, 75 reported having IBS (36.8%) compared with 44 of 189 controls (23.3%; P = .004). The odds ratio for IBS among people exposed to the Salmonella was 1.92 (95% confidence interval: 1.23–2.98). The prevalence of IBS was higher in individuals exposed Salmonella as children than in controls (35.3% vs 20.5%; P = .008), but not in individuals exposed as adults, compared with controls. After multivariate logistic regression, post-infectious IBS was independently associated with anxiety and FD. Conclusions Based on data collected from a single culture-proven foodborne Salmonella enteritidis outbreak in 1994, Salmonella -induced gastroenteritis during childhood (but not adulthood) is a risk factor for IBS.
- Published
- 2014
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