Genotyping of cryptosporidium species in cases of irritable bowel syndrome: A case control study from a tertiary care center

Abstract

Irritable bowel syndrome (IBS) is functional bowel disorder characterized by abdominal pain or discomfort and altered bowel habits in the absence of detectable structural abnormalities. Protozoan cysts are commonly found in the stool samples of patients with IBS and a rising body of evidence suggests a direct causal relationship. Cryptosporidium infection can be a potential candidate for IBS. We studied prevalence, association, and genotype of cryptosporidium at a tertiary care centre. Using a case-control design, a total of 100 cases and 100 controls were selected between 2016 and 2017. Fresh stool samples were collected and processed for microscopic examination. Positive samples were subjected to PCR RFLP for speciation and results analysed for Odd’s ratio, relative risk and relationship between variables. There was a high male preponderance (m: f=9:1). Most patients belonged to the middle age group (34.8-42.4 years). Amongst the clinical subtype IBS with diarrhoea (IBS-D) was the most common subtype (63%). Odd’s ratio for having IBS was 57.5 with cryptosporidium with a relative risk of 2.09. Adjusted Odd’s ratio for age was 1.014 suggesting a linear correlation (r value=0.07) with age. Our study shows a significant risk of developing IBS with cryptosporidium infection. The authors recommend studies with larger population samples both within the northern regions of India and across the country to determine prevalence, speciation of cryptosporidium and its relationship to IBS.