Abstract
BackgroundFunctional gastrointestinal disorders (FGID) may occur following acute gastroenteritis. This long-term complication has previously not been described after infection with the non-invasive protozoan Giardia lamblia. This study aims to characterize persistent abdominal symptoms elicited by Giardia infection according to Rome II criteria and symptoms scores.MethodsStructured interview and questionnaires 12–30 months after the onset of Giardia infection, and at least 6 months after Giardia eradication, among 82 patients with persisting abdominal symptoms elicited by the Giardia infection. All had been evaluated to exclude other causes.ResultsWe found that 66 (80.5%) of the 82 patients had symptoms consistent with irritable bowel syndrome (IBS) and 17 (24.3%) patients had functional dyspepsia (FD) according to Rome II criteria. IBS was sub classified into D-IBS (47.0%), A-IBS (45.5%) and C-IBS (7.6%). Bloating, diarrhoea and abdominal pain were reported to be most severe. Symptoms exacerbation related to specific foods were reported by 45 (57.7%) patients and to physical or mental stress by 34 (44.7%) patients.ConclusionIn the presence of an IBS-subtype pattern consistent with post-infectious IBS (PI-IBS), and in the absence of any other plausible causes, we conclude that acute Giardia infection may elicit functional gastrointestinal diseases with food and stress related symptoms similar to FGID patients in general.
Highlights
Functional gastrointestinal disorders (FGID) may occur following acute gastroenteritis
Long term abdominal symptoms may develop after acute gastroenteritis and was first described in 1962 [1]
Symptoms often fulfil the criteria for irritable bowel syndrome (IBS) and the term post-infectious irritable bowel syndrome (PI-IBS) is often used for this condition [2]
Summary
Functional gastrointestinal disorders (FGID) may occur following acute gastroenteritis. This long-term complication has previously not been described after infection with the non-invasive protozoan Giardia lamblia. This study aims to characterize persistent abdominal symptoms elicited by Giardia infection according to Rome II criteria and symptoms scores. Long term abdominal symptoms may develop after acute gastroenteritis and was first described in 1962 [1]. These symptoms are clinically similar to functional gastrointestinal diseases (FGID) and may be classified using the Rome II criteria for such illnesses. A meta-analysis found the odds of developing irritable bowel syndrome (IBS) to be increased sixfold after acute gastroenteritis [5]. Giardia infection has been found to trigger abdominal symptoms in patients with established IBS[6], and Giardia should be ruled out as a possible cause in patients (page number not for citation purposes)
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