Clinical-alimentary tractRelative importance of enterochromaffin cell hyperplasia, anxiety, and depression in postinfectious IBS
Section snippets
Subjects
Between September 1999 and July 2002, a total of 1977 questionnaires detailing the acute symptoms of gastroenteritis as well as current and previous bowel habit were sent to all subjects aged 18–75 years 3 months after a positive stool culture for Campylobacter jejuni or Campylobacter coli within the Nottingham Health Authority area. Those who responded and recorded new IBS symptoms in accordance with the Rome I criteria11 were invited to take part (PI-IBS, group 1). Our control patients (group
Patients
A total of 840 questionnaires of 1977 (42%) were returned, of which 93 were excluded for the following reasons: preexisting IBS, 46; incomplete, 38; inflammatory bowel disease, 3; liver transplant, 1; chronic pancreatitis, 1; multiple bowel operations, 1; feeding gastrostomy, 1; lymphoma, 1; dead, 1. A total of 103 (13.8%) of the 747 evaluable questionnaires fulfilled the Rome I criteria for developing new symptoms of IBS after Campylobacter infection. Of the 103 subjects, only 54 could be
Discussion
There is increasing evidence that bowel inflammation within the mucosa, myenteric plexus, and smooth muscle is associated with functional bowel disorders. A number of investigators have reported elevated numbers of inflammatory cells and mast cells in mucosal biopsy specimens in IBS,5, 21, 22, 23, 24 and laparoscopic full-thickness biopsy specimens of the jejunum have shown inflammation and neuronal degeneration in the myenteric plexus of particularly severely affected patients with IBS.25
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