Irritable Bowel Syndrome (IBS)
A recently published study surveyed the extant scientific literature and noted that post-infectious irritable bowel syndrome (PI-IBS) is a common clinical phenomenon first described over five decades ago. The Walkerton Health Study further notes that:
Between 5% and 30% of patients who suffer an acute episode of infectious gastroenteritis develop chronic gastrointestinal symptoms despite clearance of the inciting pathogens.
In terms of its own data, the “study confirm[ed] a strong and significant relationship between acute enteric infection and subsequent IBS symptoms.” The WHS also identified risk factors for subsequent IBS, including: younger age; female sex; and four features of the acute enteric illness—diarrhea for > 7days, presence of blood in stools, abdominal cramps, and weight loss of at least ten pounds. Irritable bowel syndrome (IBS) is a chronic disorder characterized by alternating bouts of constipation and diarrhea, both of which are generally accompanied by abdominal cramping and pain. In one recent study, over one-third of IBS sufferers had had IBS for more than ten years, with their symptoms remaining fairly constant over time. IBS sufferers typically experienced symptoms for an average of 8.1 days per month.
As would be expected from a chronic disorder, IBS sufferers required more time off work, spent more days in bed, and more often cut down on usual activities, when compared with non-IBS sufferers. And even when able to work, a significant majority (67%), felt less productive at work because of their symptoms. IBS symptoms also have a significantly deleterious impact on social well-being and daily social activities, such as undertaking a long drive, going to a restaurant, or taking a vacation. Finally, while a patient’s psychological state may influence the way in which he or she copes with illness, and responds to treatment, there is no evidence that supports the theory that psychological disturbances in facts cause IBS or its symptoms.
A variety of other medical problems may derive from Salmonella infections in any given case. Within several months of infection, a certain percentage of ill individuals will develop an arthritic condition known as reactive arthritis, or “Reiter’s Syndrome,” which results from an immune response to the Salmonella bacteria in the body where the immune system attacks the cartilaginous tissues in the joints. The condition frequently resolves within several months, but it can become chronic, even permanent.
Reiter’s Syndrome, which includes, and is sometimes referred to as reactive arthritis, is an uncommon, but debilitating, possible result of a Salmonella infection. Reiter’s Syndrome is a disorder that causes at least two of three seemingly unrelated symptoms: “reactive” arthritis, eye irritation, and urinary tract infection. The reactive arthritis associated with Reiter’s develops when a person eats food that has been tainted with bacteria. Reactive arthritis is characterized by the inflammation of one or more joints, following an infection localized in another portion of the body, commonly the gastrointestinal tract. The symptoms of Reiter’s Syndrome usually occur between one and three weeks after the infection.
The three most common symptoms of Reiter’s Syndrome are arthritis, eye irritation, and urinary tract symptoms. The arthritis associated with Reiter’s Syndrome typically affects the knees, ankles, and feet, causing pain and swelling. Wrists, fingers and other joints can be affected, though with less frequency. Patients with Reiter’s Syndrome commonly develop inflammation where the tendon attaches to the bone, a condition called enthesopathy. Some patients with Reiter’s Syndrome also develop heel spurs, bony growths in the heel that cause chronic or long-lasting foot pain. Arthritis from Reiter’s Syndrome can also affect the joints of the back and cause spondylitis, inflammation of the vertebrae in the spinal column. The duration of reactive arthritis symptoms can vary greatly. Most of the literature suggests that the majority of patients recover within a year. The condition, can, however, be permanent. One study found nearly 50% of patients with postdysenteric reactive arthritis continued to have symptoms roughly one year after onset.
The involvement of the eye in Reiter’s Syndrome is most commonly manifested as conjunctivitis, inflammation of the mucous membrane that covers the eyeball, or uveitis, an inflammation of the inner eye. Conjunctivitis and uveitis can cause redness of the eyes, eye pain and irritation, and blurred vision.
The third situs for Reiter’s Syndrome symptoms is the urogenital tract. This includes the prostate, urethra, and penis in men and the fallopian tubes, uterus, and vagina in women. Men may notice an increased need to urinate, a burning sensation when urinating, and a discharge from the penis. Some men also develop prostatitis. Symptoms of prostatitis include fever, chills, increased need to urinate, and a burning sensation when urinating.