# Irritable Bowel and Shigella conection



## SigKnee (Dec 15, 1999)

Irritable Bowel Can Follow DysenteryTue Jul 27, 2:35 PM ET NEW YORK (Reuters Health) - In some cases, irritable bowel syndrome can result from a bout of dysentery caused by acute intestinal infection with Shigella bacteria, according to a report from China. Yahoo! Health Have questions about your health?Find answers here. Irritable bowel syndrome, or IBS, is an often-mysterious ailment, with no obvious explanation for sufferers' bloating, pain, diarrhea and constipation. Previous studies have suggested that a history of dysentery triples the risk of IBS, the researchers explain in the medical journal Gut. Despite this clue, it's not known how often IBS or the similar condition known as functional bowel disorder (FBD) occurs after Shigella-related dysentery. Dr. G-Z Pan and colleagues from Peking Union Medical College Hospital, Beijing, looked into this question by studying 295 subjects with so-called bacillary dysentery and 243 matched "controls" without the intestinal infection. After bacillary dysentery, 22 percent of patients had FBD and 8 percent had IBS, the authors report -- significantly higher than the corresponding rates (7 percent and 1 percent, respectively) among controls. The duration of infection was an important risk factor for FBD. Compared with controls, the researchers note, patients with IBS had higher inflammatory factors in the lining and nerves of the intestines. "Our study provides new evidence in support of bacillary dysentery as a causative factor of post-infectious IBS," the authors conclude. They say their findings indicate "that the immune system and the nervous system both play important roles in the (cause) of post-infectious IBS." "There is increasing recognition of the importance of infection" in IBS, Dr. S. M. Collins from McMaster University Medical Center, Hamilton, Ontario, and Dr. G. Barbara from the University of Bologna, Italy, write in a related commentary. They add, "With emerging evidence supporting a role for inflammation and immune activation in IBS, studies are encouraged to address the influence of the microbial environment on the epidemiology and clinical expression of IBS across the globe." SOURCE: Gut, August 2004.


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## SpAsMaN* (May 11, 2002)

Post-infectious IBS?I think that we can suggest that all IBS are "post-stress".By an infection or an Acute pain,the bowel remains sensitivealtered after that.Why he still altered day after day,is a mystery.


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## eric (Jul 8, 1999)

In post infectious IBS studies they have found an increase of EC cells they release (serotonin) and mast cells. The mast cells are connected to the immune system.The HPA axis/immune system is conneted to fighting infection and stress.


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## eric (Jul 8, 1999)

Gut. 2004 Aug;53(8):1096-101. Related Articles, Links Bacillary dysentery as a causative factor of irritable bowel syndrome and its pathogenesis.Wang LH, Fang XC, Pan GZ.Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Beijing 100730, The People's Republic of China. pangz2###btamail.net.cnBACKGROUND AND AIMS: The incidence of irritable bowel syndrome (IBS) or functional bowel disorders (FBD) after bacillary dysentery (BD) has not been extensively evaluated, and little is known of the pathogenesis of post-infective (PI) IBS. Therefore, we investigated the incidence of IBS and FBD in a Chinese patient population who had recovered from BD. To further elucidate its pathogenesis, neuroimmunological changes, including interleukins (IL), mast cells, neuropeptides, and the relationship between mast cells and intestinal nerves, were investigated. METHODS: A cohort study of 295 patients who had recovered from BD (shigella identified from stool in 71.4%) and 243 control subjects consisting of patient siblings or spouses who had not been infected with BD were included in the study. All subjects were followed up using questionnaires for 1-2 years to explore the incidence of FBD and IBS, as defined by the Rome II criteria. In 56 cases of IBS (PI and non-PI) from another source, the number of mast cells in biopsy specimens from the intestinal mucosa were stained with antitryptase antibody and counted under light microscopy. Also, the relationship of mast cells to neurone specific enolase (NSE), substance P (SP), 5-hydroxytryptamine (5-HT), or calcitonin gene related peptide positive nerve fibres was observed using double staining with alcian blue and neuropeptide antibodies. In 30 cases of IBS (PI-IBS, n = 15) taken at random from the 56 cases, expression of interleukin (IL)-1alpha, IL-1beta, and IL-1 receptor antagonist (IL-1ra) mRNAs in intestinal mucosa were identified using reverse transcription-polymerase chain reaction. The above results were compared with 12 non-IBS controls. RESULTS: In the BD infected cohort, the incidences of FBD and IBS were 22.4% and 8.1% (in total)-10.2% (among those in who shigella were identified) respectively, which were significantly higher (p 0.01) than the incidences of FBD (7.4%) and IBS (0.8%) in the control cohort. A longer duration of diarrhoea (/=7 days) was associated with a higher risk of developing FBD (odds ratio 3.49 (95% confidence interval 1.71-7.13)). Expression of IL-1beta mRNA in terminal ileum and rectosigmoid mucosa was significantly higher in PI-IBS patients (p 0.01). The number of mast cells in the terminal ileum mucosa in PI-IBS (11.19 (2.83)) and non-PI-IBS patients (10.78 (1.23)) was significantly increased compared with that (6.05 (0.51)) in control subjects (p 0.01). Also, in the terminal ileum and rectosigmoid mucosa of IBS patients, the density of NSE, SP, and 5-HT positively stained nerve fibres increased (p 0.05) and appeared in clusters, surrounding an increased number of mast cells (p 0.01 compared with controls). CONCLUSIONS: BD is a causative factor in PI-IBS. The immune and nervous system may both play important roles in the pathogenesis of PI-IBS.PMID: 15247174


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## SpAsMaN* (May 11, 2002)

I like this review GUT.Can i subscibe to it?I guess that is expensive.


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## khakbar (Jun 8, 2004)

Wow! I'm glad to see this. It appeared when I posted the question, "Is this the same?" some of the responses I got appeared not to believe me. I am happy to see that a link can be made between Shigella and IBS/D. It would make sense that a bacteria as such can cause damage as it has, and that there are many ways in which a person can develop IBS/D. Many reasons are not known.


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## phyllisfin (Jan 27, 1999)

About time someone saw found the connection between IBS and shigella. I had shigella and giardia continually for the 5 years I was in India and basically lived on antibiotics. Hence, I killed off all athe good bacteria. It was because of the antibiotics that I got the IBS -- I was fine before. However, US doctors (well, 99% of them) tend to discount the relationship. I have found only one doctor in 15 years who agreed with me and that was at the Mayo Clinic in Jacksonville. He had lived/worked overseas and said it was highly probable. Go figure. What bothers me these days, which is way after all of this got started, is that I could have left India after 2 years but remained because I liked it there so much and doctors (US trained) never suggested that I get out. Now the damage has been done and I have constant reminders, not the fun kind, of my days in India. Don't get me wrong, I still love India and would love to return even for a visit, but I know that is not possible. I have enough problems in the US. Phyllis


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