Predictors for the Development of Post-infection Irritable Bowel Syndrome after Acute Gastroenteritis: A Prospective Study

Abstract

Background

Post-infection irritable bowel syndrome (PI-IBS) is seen following an episode of acute gastroenteritis (AGE). Long-term studies have suggested that the risk of developing PI-IBS increases up to sixfold after gastrointestinal infection. This study aims to evaluate the incidence of PI-IBS and identify its risk factors.

Methods

This prospective study was performed over a period of 1 year on AGE patients admitted to a tertiary care hospital in South India. Clinical and demographic characteristics were noted, and risk factors were evaluated. An IBS questionnaire ruled out ongoing or pre-existing IBS. The patients were followed up after 6 months to look for the development of IBS (Rome IV criteria).

Results

Out of 100 hospitalized AGE patients, one-fourth developed PI-IBS after 6 months. Out of them, 18 patients had the diarrhea-predominant (IBS-D) type, and the remaining 7 had the constipation-predominant (IBS-C) type. The factors that were significantly associated with PI-IBS were younger age, longer duration of AGE, depression, and abdominal cramps. On multivariate logistic regression analysis, longer duration of AGE (>7 days; p-value = 0.0040) and presence of abdominal cramps (p-value = 0.0130) were found to significantly influence the development of PI-IBS at 6 months.

Conclusion

One-fourth of the patients in our study developed PI-IBS. Younger age, depression, longer duration of diarrhea, and abdominal cramps were statistically significant risk factors for the development of PI-IBS. Physicians should keep a high suspicion for PI-IBS in patients with such predisposing risk factors.

Keywords

bowel - Bristol - constipation - depression - diarrhea - gastroenteritis - infection - PI-IBS - Rome - stool

Ethical Clearance

The study was approved by the Institutional Ethics Committee of JNMC (KAHER).

Author Contributions

R.A. was responsible for data collection, analysis, manuscript writing, and the formulation of the study protocol. M.P. contributed by assisting with data collection, supervising data interpretation, and supporting the writing process. P.M. participated in data collection, while D.M. was involved in the scientific writing. R.S.P. played a key role in developing the study protocol, overseeing the study, contributing to manuscript writing, and revising the final draft.

Data Availability Statement

There is no data associated with this work.

Publikationsverlauf

Eingereicht: 26. Mai 2025

Angenommen: 28. Juli 2025

Artikel online veröffentlicht:
06. Oktober 2025

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