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Research Outline
Prepared for Onikepe A. | Delivered May 31, 2020
Clostridium difficile-Casused IBS
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Goals
To determine whether the infection
C
l
o
s
t
r
i
d
i
u
m
difficile or C. diff can cause irritable bowel syndrome (IBS) for educational purposes.
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Early Findings
Based on three medical studies conducted between 2008 and 2016, IBS can be caused by a C. diff infection in between 10% and 33% of patients.
New-onset IBS common after C. difficile infection
This article by
Wadhwa A, et al.
was published in the journal
Aliment Pharmacology and Therapeutics
in August 2016.
Its conclusion is that "patients with Clostridium difficile infection have a
high risk
for developing post-infectious irritable bowel syndrome, particularly those with longer duration of C. difficile infection, anxiety and higher BMI."
The conclusion is based on a study in which it was "found that a
quarter
of... survey responders without IBS prior to CDI have developed PI-IBS following the CDI."
Of the individuals who developed PI-IBS, "
52%
had mixed IBS and
40%
had diarrhea-predominant IBS."
People who had C. diff symptoms for
longer than a week
, anxiety, or a higher BMI were more susceptible to PI-IBS.
Post-Infectious Irritable Bowel Syndrome with Functional Diarrhea Following C. difficile Infections: Case Studies of Responses Using Serum-Derived Bovine Immunoglobulin
This article by
Carl Crawford and Raymond Panas
was published in the Journal of Gastroenterology and Hepatology Research in 2015.
While it mostly discusses how PI-IBS can be treated with
serum-derived bovine immunoglobulin
, it also discusses how IBS manifests in patients with gastrointestinal infections such as C. diff.
It states, "post-infectious IBS (PI-IBS) may occur in
up to nearly a third
of gastroenteritis patients" and the two patients studied for the article both exhibited symptoms of IBS-D "following a
C. difficile infection
."
Long-Term Gastrointestinal Complications of Clostridium Difficile-Associated Diarrhea (CDAD)
This article by
Saurabh Sethi
was published as a dissertation at The University of Texas School of Public Health in 2008.
It discusses the theory that the "increased use of
broad spectrum antibiotics
" used to treat C. diff and "the introduction of a clonal hyper-virulent strain called the
BI strain
." are responsible for the increase in cases of Clostridium difficile -associated diarrhea (CDAD), including "long-term consequences such as
irritable bowel syndrome
(IBS), chronic dyspepsia/diarrhea, and other GI effects."
The authors hypothesize that patients that develop CDAD as a short-term complication of a C. diff infection are
more likely to develop IBS
in the long-term.
Following a study of adult CDAD patients at St. Luke's Episcopal Hospital, Houston who had developed CDAD after a C. diff infection, it was found that
10%
also developed new onset IBS "
within six months
after initial infection compared to matched controls."
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