The Known Cause to IBS

ibs Sep 04, 2017

With the rise of IBS to almost 20% of those in North America, the need to understand the cause becomes increasingly important for prevention and appropriate treatment.

The Known Cause to IBS

Recently, traveller’s diarrhea and gastroenteritis (aka food poisoning) have come into the spotlight as one of the major triggers in the development of IBS. This is referred to as post-infectious IBS or PI-IBS.

What is Gastroenteritis?

Gastroenteritis refers to inflammation of the stomach and small intestines, typically of viral or bacterial origin. Contamination of food or water may spread bacteria including, E. coli, Shigella, Salmonella, Camphylobacter and parasites Blastocystis hominis and Giardia lamblia leading to the infection.

Depending on the nature of the bug the symptoms can range from the typical ‘flu’ with diarrhea and vomiting to more severe symptoms of bloody diarrhea and abdominal pain.

Surprisingly, studies show a tenfold increase in developing IBS after acute gastroenteritis 24 to 36 months after the initial infection. Even 3 years after an infection the risk of developing IBS remains fivefold.

The Walkerton Health Study (WHS) found 15.4% prevalence of IBS eight years after a large outbreak of gastroenteritis from municipal water contamination in Walkerton, Ontario. Overall, researchers
estimate that 1 in 10 adults develop IBS after infection.

Who is susceptible?

Studies find that the risk of developing IBS after an infection depends on a number of factors:

  • Prolonged fever or weight loss during infection
  • Increased intestinal permeability (leaky gut) and loose stool during infection
  • Antibiotic treatment
  • History of anxiety or depression
  • Younger
  • Female

Although the exact mechanism as to how gastroenteritis leads to IBS has yet to be confirmed, possible insights include;

  • Residual inflammation in the mucosa of the gut
  • Alterations in intestinal permeability (leaky gut)
  • Persistent changes in mucosal immune and hormone cells (enterochromaffin, mast cells) nerves and the gut bacteria (microbiota)

How to Prevent PI-IBS

The key to reducing your risk of IBS is to prevent infections in the first place. This includes the norms such as proper hygiene, frequent hand washing and avoiding foods that have been left out or improperly stored.

If you have had food poisoning or are travelling, here are some key tips to ensure the health of your gut:

  1. Gut repair – give your gut essential nutrients, such as L-glutamine, to repair leaky gut
  2. Reduce inflammation in the gut – eat organic chemical free foods. Glycophosphates (pesticides) are shown to alter the permeability of the gut, aka lead to leaky gut
  3. Natural probiotics/fermented foods to improve the bacterial balance
  4. Drink filtered water while travelling
  5. Avoid (as much as possible) street food with poor storage of food
  6. Oregano-oil has been shown to prevent traveller’s diarrhea with 1-2 caps per day with foods

At The IBS Academy we strive to ensure your health through the gut, so if you have any questions please reach out to us!

In best of health,

Dr. Robyn Murphy
The IBS Academy

Resources:
1. Marshall, J. K., M. Thabane, A. X. Garg, W. F. Clark, P. Moayyedi, S. M. Collins, and
Walkerton Health Study Investigators. “Eight Year Prognosis of Postinfectious Irritable
Bowel Syndrome Following Waterborne Bacterial Dysentery.” Gut 59, no. 5 (May 1,
2010): 605–11. doi:10.1136/gut.2009.202234.
2. Marshall, J. K., M. Thabane, A. X. Garg, W. Clark, J. Meddings, S. M. Collins, and for the
WEL Investigators. “Intestinal Permeability in Patients with Irritable Bowel Syndrome
after a Waterborne Outbreak of Acute Gastroenteritis in Walkerton, Ontario.”
Alimentary Pharmacology & Therapeutics 20, no. 11–12 (December 1, 2004): 1317–22.
doi:10.1111/j.1365-2036.2004.02284.x.
3. Spiller, Robin, and Klara Garsed. “Postinfectious Irritable Bowel Syndrome.”
Gastroenterology 136, no. 6 (May 2009): 1979–88. doi:10.1053/j.gastro.2009.02.074.
4. Thabane, Marroon, and John K Marshall. “Post-Infectious Irritable Bowel Syndrome.”
World Journal of Gastroenterology : WJG 15, no. 29 (August 7, 2009): 3591–96.
doi:10.3748/wjg.15.3591.
5. Thabane, M., D. T. Kottachchi, and J. K. Marshall. “Systematic Review and Meta-Analysis:
The Incidence and Prognosis of Post-Infectious Irritable Bowel Syndrome.” Alimentary
Pharmacology & Therapeutics 26, no. 4 (August 1, 2007): 535–44. doi:10.1111/j.1365-
2036.2007.03399.x.

6. Schwille-Kiuntke, J., N. Mazurak, and P. Enck. “Systematic Review with Meta-Analysis:
Post-Infectious Irritable Bowel Syndrome after Travellers’ Diarrhoea.” Alimentary
Pharmacology & Therapeutics 41, no. 11 (June 2015): 1029–37. doi:10.1111/apt.13199.

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