Never underestimate the so-called intestinal flu: acute gastroenteritis can leave heavy after-effects, persisting for up to 5 years. In fact, it can evolve into irritable bowel syndrome (IBS), even in severe form. This was discovered in a study published in ‘Gut’ (British Medical Journal group) by a group of researchers from the Catholic University of the Sacred Heart-Gemelli Polyclinic Foundation in Rome. Viruses such as Sars CoV-2 and aggressive bacteria such as Campylobacter and Enterobacteriaceae, responsible for many summer gastrointestinal infections, are being blamed. In other words, IBS could represent yet another ‘legacy’ of Covid, or even a sequel to the ‘Montezuma’s curse’ or ‘traveler’s diarrhea’.
“Irritable bowel syndrome, a disorder that involves the gut-brain axis – explains Giovanni Cammarota, full professor of Gastroenterology at the Catholic University and director of the UOC of Gastroenterology at Gemelli – is characterized by abdominal pain with a ‘capricious’ onset, bloating, constipation alternating with diarrhea. According to estimates by Sige (Italian Society of Gastroenterology), it affects 20-40% of the Italian population, with a predilection for women and the age group between 20 and 50 years old”. For some it is a mild disorder, but for many others it is a condition that heavily impacts daily life and quality of life. The causes are neither well defined nor univocal, and this does not help to find effective therapeutic solutions. A contribution to filling this gap comes from the new work, which has put the spotlight on the pandemic coronavirus and on aggressive bacteria for the intestine and pro-inflammatory ones such as Proteobacteria and Enterobacteriaceae.
“After having carefully reviewed all the scientific literature on the appearance of IBS following an episode of gastroenteritis – explains Gianluca Ianiro, professor of Gastroenterology at the Cattolica, gastroenterologist at Gemelli and corresponding author of the study – we highlighted that the symptoms of IBS appear in one in seven people after an episode of gastrointestinal infection. The analysis of the data also allowed us to ascertain that, after this ‘trigger’, the disorders persist for 6-11 months in at least half of the people affected by acute gastroenteritis; but other studies suggest that the duration of IBS could extend up to over 5 years”. Not only that. “The presence of anxiety disorders, before the episode of gastroenteritis – underlines Serena Porcari, contract at the UOC of Gastroenterology at Gemelli and first author of the research – also triples the risk of developing IBS”.
“As for infectious agents – Porcari specifies – our study has highlighted that the highest incidence of IBS occurs after acute gastroenteritis from Campylobacter (21%); the probability of developing IBS is 5 times higher after infection from Proteobacteria or Sars-CoV-2, and 4 times higher after infections from Enterobacteriaceae”.
“The physiopathology of IBS – comments Antonio Gasbarrini, co-author of the work and dean of the Faculty of Medicine and Surgery of the Catholic University, professor of Internal Medicine and director of the UOC of Internal Medicine and Gastroenterology of Gemelli – is not yet sufficiently known and in the collective imagination, but also in the opinion of many doctors, what goes under the name of IBS are disorders with an important psychological component and not an ‘organic’ disease. This involves the risk of underestimating and under-treating patients, abandoning them to their disorders”.
“Since gastroenteritis is a very common occurrence, the results of our study – Gasbarrini remarks – could be relevant from a public health perspective and lead doctors to follow more carefully the evolution of these disorders in a patient who has presented an episode of acute gastroenteritis”.
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