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The long-term functional consequences of acute infectious diarrhea

Cocciolillo, Sila; Collins, Stephen M.

Current Opinion in Gastroenterology: January 2016 - Volume 32 - Issue 1 - p 1–6
doi: 10.1097/MOG.0000000000000233
GASTROINTESTINAL INFECTIONS: Edited by Mitchell B. Cohen

Purpose of review The study reviews recent publications that build on previous studies showing that acute enteric infection can produce persistent dysfunction in the lower gut (postinfectious irritable bowel syndrome) and proximal gut (postinfectious functional dyspepsia). The review addresses risk factors, the pathophysiological basis of persistent gut dysfunction, and the factors that initiate and maintain it.

Recent findings Recent work has identified several loci of host genetic predisposition to these syndromes that focus attention on host immune responses that may lead to gut dysfunction, including changes in intestinal barrier function and cytokine responses to the initial infection. Human and animal studies identify changes in the serotonergic and cannabinoid pathways regulating visceral pain responses and gut motility. Recent work has also focused attention on the putative role of the intestinal microbiota or dysbiosis in maintaining gut dysfunction and this is reviewed in depth.

Summary The development of long-term consequences following an acute episode of gastroenteritis reflects a convergence of host factors that include genetic predisposition and psychological factors, as well as the development of intestinal dysbiosis. It is anticipated that future research will generate biomarkers of susceptibility as well as novel microbiota-directed preventive and therapeutic strategies.

Department of Medicine, Faculty of Health Sciences, Farncombe Family Digestive Health Research Institute, Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada

Correspondence to Stephen M. Collins, MBBS, FRCPC, FRSC, Faculty of Health Sciences, Room 2E 17, McMaster University Medical Centre, Hamilton, Ontario L8N 3Z5, Canada. Tel: +1 905 525 9140 x22184; fax: +1 905 524 1346; e-mail: scollins@mcmaster.ca

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