IBS, also known as Irritable bowel syndrome, can certainly be unsettling. Unpredictable instances of abdominal distress, bloating and diarrhea may interfere with daily tasks.
Post-infectious IBS shares similar symptoms but originates from different causes and instigators.
The treatment approaches for post-infectious IBS might appear identical but it's important to consider some minor disparities.
In this segment, we provide a comprehensive overview of post-infectious IBS, including its duration and available treatments.
Understanding Post-Infectious IBS
Post-infectious Irritable Bowel Syndrome (PI-IBS), is a particular category of IBS that surfaces post an infection, usually gastroenteritis ("stomach flu") or food poisoning. It could also emerge from any infection that results in the inflammation of your stomach lining due to bacteria, viruses or parasites according to the National Library of Medicine.
Should you continue suffering abdominal discomforts like bloating, gas and diarrhea following the resolution and treatment of your said infection - PI-IBS might be what you're dealing with.
Actually, among all known cases of IBS within America which accounts for around 10% to 15% per the NLM%and(the)brain., one study published in April 2021 by Gastroenterology Clinics of North America uncovered that over half these instances can actually be traced back as PI-IBS.
Do bear in mind though that experiencing diarrhea is a prevalent side effect when on antibiotics as pointed out by the Cleveland Clinic. Nonetheless, this symptom is generally mild and short-term and does not accompany significant abdominal pains & discomfort seen during PI-IBS.
Underlying Causes
The exact root cause behind post-infectious IBS (PI-IBS), similar to regular IBS, remains undefined. However, there are certain factors that could potentially heighten the chances of manifesting this condition, states Sarah Robbins, MD, a gastroenterologist practicing in British Columbia:
- A severe infection
- Prolonged periods of high fever
- Use of antibiotics during sickness
- Psychological elements like stress and depression
- An imbalance between good and harmful bacteria or dysbiosis i
- Changes in immune system impacting gut functionality
- Persistent inflammation of the gastrointestinal tract
"Compared to conventional IBS that typically results from diet choices and levels of stress, PI-IBS tends to emerge due to alterations in our gut microbiome," explains Andrew Boxer, MD, a certified gastroenterologist based out of New Jersey.
Duration of Post-Infectious IBS
Unlike the chronic form of IBS that typically necessitates ongoing symptom control, post-infectious (PI-IBS) is generally a transient condition.
The period it takes for PI-IBS to resolve isn't uniform and differs from person to person. "In some instances, symptoms may disappear after just a few days, but more often than not, they linger for weeks or even up to two months," says Dr. Boxer.
There are rare scenarios where PI-IBS persists for an extended duration – sometimes years. For example, Dr. Boxer has treated veterans who contracted gastrointestinal infections while abroad and ended up suffering from PI-IBS persisting several years following their illness.
Dr.Robbins adds that "Around 25% of individuals who have incurred bacterial gastroenteritis report having consistent IBS-like symptoms six months after their initial infection." While some patients experience resolution within a year others continue facing these issues in many succeeding years.
As time passes it can become difficult distinguishing between chronic and post-infectious forms of IBS mentions Dr Robbins. If symptoms continue unabated, medical professionals alter the approach - shifting focus on symptom management rather than striving towards complete cure; regardless of the cause behind its onset
Several factors might prolong PI-IBS including severity of initial infection or underlying mental conditions like depression and anxiety as per Dr Robbins
Interestingly there seems to be strong correlation between anxiety disorders and irritable bowel syndrome which are often managed using similar strategies such as relaxation techniques or antidepressants according to The UNC Center for Functional GI & Motility Disorders.
Therapeutic Choices for Post-Infectious Irritable Bowel Syndrome
We can certainly treat post-infection IBS (PI-IBS) and there are various routes to manage the symptoms. Moreover, the treatment approach is comparable with normal IBS.
The method of treatment could concentrate on repairing the gut microflora. However, Dr. Robbins mentions that it's predominantly about "alleviating discomfort". Management may encompass food alterations, prescribed drugs, incorporating probiotics, behavioural treatments in conjunction with counseling," she points out.
Dr. Robbins advises her patients to adapt these strategies:
1. Consider Altering Your Eating Habits
For many individuals suffering from IBS, implementing a low-FODMAP diet can prove beneficial. Derived from Fermentable Oligo-, Di-, Mono-saccharides And Polyols, FODMAPs are short-chain carbohydrates or sugars that often pose difficulty for the small intestine during digestion, according to Johns Hopkins Medicine.
Foods rich in FODMAPs listed by Johns Hopkins Medicine include:
- Yogurt and ice cream known as dairy products
- Cereal, bread and crackers or wheat-based items
- Beans
- A variety of vegetables like asparagus, onion, and garlic
- Some fruits such as apples, cherries, pears and peaches
A dietary plan with decreased concentrations of these FODMAPS may assist in mitigating symptoms linked to both PI-IBS and standard IBS. Low-FODMAP foods recommended by Johns Hopkins Medicine consist of:
- Eggs
- Meat products including seafood
- Almond milk
- Rice
- Quinoa
- Potatoes -Eggplant
-Grapes
-Berries blue-colored (blueberries)
2. Consider Probiotic Supplements
Dr. Robbins explains that while the number of specific studies is limited, and many fail to differentiate between normal IBS and post-infectious (PI)-IBS, there does appear to be some indication that using probiotics might alleviate the symptoms of PI-IBS following gastrointestinal distress.
A comprehensive review from August 2013 published in the Indian Journal of Medical Research states that although evidence supporting a clearcut benefit from probiotics isn't robust enough for it be recommended as primary treatment option for IBS, supplementing with specific strains such as Lactobacilli and Bifidobacteria could potentially result in an overall reduction in symptomatology.
Dr.Robbins reassures us by stating "In general, supplements containing probiotics are believed to be safe and well-tolerated for most individuals". However, she emphasizes that consultation with a healthcare provider should always precede starting them - especially if you have any pertinent underlying medical conditions.
3. Explore the Option of Medication
The use of medication for tackling short-term PI-IBS symptoms can be an option if other modifications to your lifestyle don't bring relief. Here's a list of potential medicine categories that Dr. Robbins suggests:
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Antispasmodics: Drugs like Dicyclomine (Bentyl) or Hyoscyamine, which are available via prescription, might help minimize abdominal pain temporarily.
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Antidiarrheals: If you're looking to get some respite from diarrhea episodes, Imodium could prove beneficial.
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Laxatives: For individuals finding it challenging dealing with constipation, MiraLax or Dulcolax might offer a solution.
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Antidepressants: An unexpected solution for managing both bowel routines and stomach discomfort could come in the form of low doses of tricyclic antidepressants (such as Amitriptyline) and SSRIs (like Paroxetine); these are also prescribed medications.
4. Incorporating Talk Therapy and Stress Management Techniques
Experiencing life with PI-IBS can undeniably result in high-stress levels. The mere anticipation of an oncoming flare-up could increase your anxiety, thereby heightening the severity of your GI symptoms.
As a result, managing emotional states becomes essential. Weaving techniques like deep breathing exercises, yoga, or meditation into daily routines can help manage stress levels. Furthermore, engaging in talk therapy sessions may greatly aid in long-term management of emotions associated with both PI-IBS and IBS.
By far one of the most effective types has proven to be Cognitive-behavioral therapy (CBT). This methodology has undergone numerous clinical trials showing consistent improvement among individuals suffering from IBS symptoms according to a comprehensive review posted in July 2017 on Psychology Research and Behavior Management. CBT helps you reframe your thoughts regarding not only your condition but also concerning stress itself.
5. Include Physical Activity into Your Routine
A tiny study conducted in January 2015, as featured in the World Journal of Gastroenterology, suggests that boosting physical activity can lead to positive long-term impacts on IBS symptoms and associated psychological problems linked with this condition.
However, bear in mind that you should tread lightly if you're currently convalescing from an infection. Initiate with low-impact exercise such as gentle stretching or taking a leisure walk; yoga would also be a great option. Thereafter, depending on your PI-IBS symptoms' severity and regularity, up your game gradually.
(Sporting activities may sometimes trigger bowel movements—an undesirable side effect for those combating diarrhoea triggered by PI-IBS.)
6. Antibiotics for Gut
You may still have a lingering GI infection if you are witnessing post-infection IBS (PI-IBS) symptoms. Stool samples, among other tests, can be beneficial in figuring out whether there's an existing infection or not and then your GP could recommend appropriate antibiotics based on the results.
Rifaximin, which is a non-absorbable antibiotic, frequently comes as a prescription to handle bacterial complications like E. coli and occasionally IBS as suggested by Mayo Clinic.
When You Should Consult a Physician
If there are alterations in your bowel movement patterns that result in discomfort or pain, it's critical that you seek medical attention to identify the source of these changes. You might have PI-IBS if symptoms such as diarrhea, bloating and/or constipation manifest after contracting a GI infection. The aforementioned treatments can prove beneficial.
Dr. Boxer points out; "It is important to discuss any unique signs and symptoms with your physician".
Be vigilant for indications like weight loss, blood presence in feces, tiredness, syncope episodes or fainting spells, trouble swallowing food items and persistent diarrhea without regular defecation pattern resuming over several weeks duration. Nausea post meals followed by vomiting combined with meal-induced pain could also be suggestive of an imminent severe health problem requiring immediate clinical evaluation or diagnostic tests such as colonoscopy scan,endoscopic procedure or MRI scan.
Although not fatalistic by nature,the affliction termed as Post Infection Irritable Bowel Syndrome (PI-IBS) can be controlled effectively. Patience is key while experiencing aftermath effects subsequent to being infected but make sure any doubts get clarified from healthcare provider.
