Post-Infectious Irritable Bowel Syndrome with Functional Diarrhea Following C. difficile Infections: Case Studies of Responses Using Serum-Derived Bovine Immunoglobulin

Abstract

Introduction: Post-infectious irritable bowel syndrome with diarrhea (PI-IBS-D) can result from any number of enteric infections. Two case histories investigate patients with IBS-D following recurrent Clostridium difficile infections and the benefits found using a prescription medical food, serum-derived bovine immunoglobulin/protein isolate (SBI), which is indicated for the management of chronic loose and frequent stools in such conditions as IBS-D and HIV-associated enteropathy. Case Presentations: Both patients were treated for relapsing C. difficile infections and eventually cleared. Despite negative C. difficile cultures, the 39-year old Caucasian female patient had diarrhea that never resolved and cholestyramine resulted in significant bloating. The severity of her condition led her to file for disability. Within two weeks of starting SBI 5 g QID, her diarrhea had resolved but returned upon discontinuation. SBI was restarted resulting again with resolution of her diarrhea. She continues on SBI 5g BID and has returned back to work. The second patient, 57-year old Caucasian female experienced ongoing diarrhea with alternating bouts of constipation. Upon use of SBI 5g BID, she noticed improvement within a few days. Therapy was reduced to SBI 5g QD to avoid possible constipation and reports regulation of her bowel habits. Discussion: These cases highlight the difficulties that result from C. difficile associated PI-IBS, the management that SBI can provide when considered an option for therapy, and the impact disease manifestations can have on quality of life. These cases further suggest the need for additional study of this nutritional agent in post-C. difficile infectious IBS patients.