Psychometric scores and persistence of irritable bowel after Campylobacter concisus infection

Abstract

Objective. Gastroenteritis with Campylobacter concisus is an emerging infection, but the risk of irritable bowel syndrome (IBS) following it is unknown. Material and methods. In a prospective, community-based study of gastroenteritis with C. concisus and C. jejuni/coli, we invited adult patients to participate in a questionnaire study, including IBS symptoms and psychometric scores, at baseline and at 6 months. We estimated adjusted RR (RR^adj) (for age, sex and comorbidity) for IBS as the primary outcome. Results. The development of IBS symptoms at 6 months was reported in 26/106 (25%) patients with C. concisus infection, and in 30/162 (19%) of C. jejuni/coli patients. The baseline predictors for IBS in C. concisus infection were high anxiety scores (RR^adj 2.0; 95% CI 1.1–3.6, p < 0.05), chills (RR^adj 1.9; 95% CI 1.0–3.6, p < 0.05), headache (RR^adj 2.5; 95% CI 1.1–6.0, p < 0.05), dizziness (RR^adj 2.6; 95% CI 1.2–5.8, p < 0.05) and muscle ache (RR^adj 3.6; 95% CI 1.4–8.9, p < 0.01). For all Campylobacter patients (n = 268), we confirmed previous reports of anxiety (RR^adj 2.0; 95% CI 1.3–3.1), depression (RR^adj 2.3; 95% CI 1.3–4.0) and high somatization scores (RR^adj 3.0; 95% CI 1.5–6.0) as predictors for post-infectious IBS (PI-IBS). Conclusions. Gastroenteritis with C. concisus carries a 25% risk of IBS at 6-month follow-up. The risk factors for IBS are chills, headache, dizziness and muscle ache in the acute stage, as well as preexisting high psychometric scores for anxiety. Our findings suggest that psychological factors play a role in the development of PI-IBS.

Key Words::

• anxiety
• Campylobacter concisus
• Campylobacter jejuni
• depression
• diarrhea
• gastroenteritis
• irritable bowel syndrome
• psychometric scores

Acknowledgments

We are grateful for assistance from the microbiology staff in the feces laboratory at the Department of Clinical Microbiology, Aalborg University Hospital; from Kristoffer Koch MD and Michael Dalager-Pedersen MD for help with the statistical analyses; and from the patients who took part in the study. This work was supported by grants from Hertha Christensen foundation, Heinrich Kopp's legate, and The A. P. Møller Foundation for the Advancement of Medical Science. The authors declare that they have no conflicting interests in relation to this work.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.