Risk Factors of Developing Postinfectious Irritable Bowel Syndrome in Shigellosis Patients, 5 Years After Hospitalization During the Outbreak

Abstract

Background. Irritable bowel syndrome (IBS) can be triggered by bacterial dysentery. This study aimed to investigate postinfectious IBS and its risk factors after the shigellosis outbreak in hospitalized patients. Methods. This retrospective study was conducted in 2020-2021 in referral hospitals for Shigella gastroenteritis during the 2014 shigellosis outbreak in Isfahan. The Shigella-infected group included hospitalized shigellosis patients with clinical symptoms and positive stool culture. The control group included patients matched pairwise on age and sex to the Shigella-infected group, admitted to the same hospitals in the same period with diagnoses other than shigellosis. Both groups had no history of diagnosed IBS before the outbreak. The incidence of IBS (according to Rome-III criteria) and its related factors was compared between the 2 groups 5 years after infection. Results. Of 619 participants, 220 (35.5) were in the Shigella-infected group. The 5-year incidence of IBS was 31.8 and 5.7 in the Shigella-infected and control groups, respectively. Multivariate analysis showed that shigellosis was significantly associated with increased risk of IBS (odds ratio OR, 17.18 95% confidence interval {CI}, 9.37-31.48). Multivariate analysis indicated education level (OR, 4.15 95% CI, 1.47-11.73), diarrhea lasting >4 days (OR, 1.69 95% CI, 1.17-2.44), and abdominal cramps during the infection (OR, 0.27 95% CI, .77-.95) associated with postinfectious IBS (P < .05). Conclusions. Hospitalized patients with Shigella gastroenteritis are at increased risk of IBS within 5 years after infection. Factors such as higher education level and the absence of abdominal cramps and diarrhea persisting for >5 days during hospitalization can further increase this risk.