Publication date: Jul 16, 2024

Disorders of gut-brain interaction may arise after acute gastroenteritis. Data on the influence of pathogen type on the risk of postinfection IBS (PI-IBS), as on postinfection functional dyspepsia (PI-FD), are limited. We conducted a systematic review and meta-analysis to determine prevalence of PI-IBS or PI-FD after acute gastroenteritis. We included observational studies recruiting ≥50 adults and reporting prevalence of IBS or FD after acute gastroenteritis with ≥3-month follow-up. A random effects model was used to estimate prevalence and ORs with 95% CIs. In total, 47 studies (28 170 subjects) were eligible. Overall prevalence of PI-IBS and PI-FD were 14. 5% and 12. 7%, respectively. IBS persisted in 39. 8% of subjects in the long-term (>5 years follow-up) after diagnosis. Individuals experiencing acute gastroenteritis had a significantly higher odds of IBS (OR 4. 3) and FD (OR 3. 0) than non-exposed controls. PI-IBS was most associated with parasites (prevalence 30. 1%), but in only two studies, followed by bacteria (18. 3%) and viruses (10. 7%). In available studies, Campylobacter was associated with the highest PI-IBS prevalence (20. 7%) whereas Proteobacteria and SARS-CoV-2 yielded the highest odds for PI-IBS (both OR 5. 4). Prevalence of PI-FD was 10. 0% for SARS-CoV-2 and 13. 6% for bacteria (Enterobacteriaceae 19. 4%). In a large systematic review and meta-analysis, 14. 5% of individuals experiencing acute gastroenteritis developed PI-IBS and 12. 7% PI-FD, with greater than fourfold increased odds for IBS and threefold for FD. Proinflammatory microbes, including Proteobacteria and subcategories, and SARS-CoV-2, may be associated with the development of PI-IBS and PI-FD.

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