Original Contribution

The American Journal of Gastroenterology (2007) 102, 1064–1069; doi:10.1111/j.1572-0241.2007.01084.x

Irritable Bowel Syndrome in Persons Who Acquired Trichinellosis

Mujde Soyturk MD1, Hale Akpinar MD1, Oguz Gurler MD2, Edoardo Pozio PhD3, Ismail Sari MD4, Servet Akar MD4, Mesut Akarsu MD1, Merih Birlik MD4, Fatos Onen MD4 and Nurullah Akkoc MD4

  1. 1Department of Internal Medicine, Division of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkey
  2. 2Department of Internal Medicine, Division of Rheumatology, Adnan Menderes University School of Medicine, Aydin, Turkey
  3. 3Department of Infectious, Parasitic and Immunomediated Diseases, Instituto Superiore di Sanità, Rome, Italy
  4. 4Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey

Correspondence: Dr Müjde Soytürk, Department of Internal Medicine, Division of Gastroenterology, Dokuz Eylul University School of Medicine, 35340, Inciralti, Izmir, Turkey.

Received 17 July 2006; Accepted 26 November 2006.

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Abstract

BACKGROUND AND AIM:

 

The postinfectious irritable bowel syndrome (PI-IBS) frequently follows bacterial infections. Since people suffering from PI-IBS and Trichinella spiralis–infected mice develop similar findings, this animal model has been successfully used for PI-IBS studies; however, IBS has never been studied in humans after trichinellosis. The aim of this study was to evaluate the IBS symptoms in people who had acquired trichinellosis.

PATIENTS AND METHODS:

 

A large outbreak of trichinellosis caused by Trichinella britovi occurred in Izmir, Turkey, in 2003–2004. The diagnosis of trichinellosis was confirmed by serology and muscle biopsy. After clinical and laboratory evaluations, 72 patients (38 women, 34 men, mean age 33.2 plusminus 10.4 yr) with trichinellosis without preexisting IBS were enrolled in the study. Noninfected people (N = 27) were used as control group. A questionnaire was developed to assess symptoms of IBS and alarm symptoms. The first interview was done face-to-face. After 2, 4, and 6 months of the first interview, the questionnaire was readministered to the patients without any information on the occurrence of a previous trichinellosis syndrome, while it was applied after a year only to the patients who had suffered IBS symptoms according to at least one of the previous interviews.

RESULTS:

 

According to Rome II criteria, PI-IBS developed in 10 of 72 (13.9%) people with confirmed trichinellosis, who had no preexisting IBS. The rate of PI-IBS was 13.9% and 13.9% at the 4th and 6th months, respectively. The symptoms of PI-IBS persisted in five of them up to 1 yr. People without trichinellosis did not develop any IBS symptoms.

CONCLUSIONS:

 

This is the first report of the development of PI-IBS after T. britovi. Consequently, IBS can be considered as a secondary syndrome induced by trichinellosis.

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