Irritable bowel syndrome (IBS) is a combination of chronic and recurrent symptoms such as constipation, diarrhea, bloating and/or abdominal pain, which do not appear to have a base of biochemical or structural anomalies detectable by conventional laboratory methods. IBS affects approximately 9–13% of the general population at any time .
IBS is defined by recurrent abdominal pain, on average at least one day per week over the last 3 months; abdominal pain episodes must be associated with two or more of the following: to be related to defecation, the intestinal transit frequency to be modified, a change in the consistency of the seat to occur. Symptoms must have started at least 6 months before in accordance with the Rome IV diagnostic criteria .
Post-Infectious Irritable Bowel Syndrome (PI-IBS) is characterized by the occurrence of the symptoms mentioned in the diagnostic criteria for IBS (the most recent criteria being those in Rome IV) . They occur as a result of an episode of acute infectious gastroenteritis characterized by two or more of the following symptoms: diarrhea, vomiting, fever, and a positive result of the etiologic agent in the stool .
The incidence of Clostridium difficile infection (CDI) has increased over the last decade and has become an important cause of mortality, morbidity and a challenge to the current medical system [5, 6, 9].
A quarter of patients report symptoms consistent with IBS ≥6 months following their CDI episode. The results are significant considering the progressively increasing burden of CDI. This makes it important to consider the possibility of PI-IBS when patients with a history of CDI present with ongoing gastrointestinal symptoms. This patients may be retreated for CDI inappropriately. Additionally, longer duration of CDI symptoms is also moderately associated. Considering the significant incidence of CDI PI-IBS, retreatment for recurrence should only be offered after laboratory confirmation of the diagnosis [7, 8, 14]. There are studies in the literature that investigate the risk of PI-IBS and CDI, but available data is scarce .
The objectives of this study were to asses the risk of PI-IBS following a CDI. We also evaluated if there is a correlation between the onset of PI-IBS and the severity of CDI.