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Irritable bowel syndrome following Clostridium difficile infection

Dayananda, Pete; Wilcox, Mark H.

Current Opinion in Gastroenterology: January 2019 - Volume 35 - Issue 1 - p 1–5
doi: 10.1097/MOG.0000000000000490

Purpose of review The aim of this review was to provide an overview of the current understanding of the diagnosis, pathophysiology, and the role of the gut microbiome in Clostridium difficile infection (CDI)-related postinfectious irritable bowel syndrome (PI-IBS).

Recent findings PI-IBS is a recognized pathological entity and was estimated to affect 1 in 10 patients with infectious enteritis. CDI remains a major healthcare burden worldwide with a one in four chance of recurrence of symptoms following treatment. While there is growing interest in functional gastrointestinal disorders including PI-IBS, studies examining the prevalence and risk factors of CDI-related PI-IBS remain scarce. One of many proposed mechanisms for PI-IBS is related to dysbiosis of the gut microbiota, which is the hallmark of CDI pathogenesis. Therefore, restoration of the gut microbiota, which is associated with successful outcomes in CDI, may be a potential treatment option for PI-IBS. However, two randomized controlled trails exploring the restoration of the gut microbiota using faecal microbiota transplant came to differing conclusions.

Summary PI-IBS, particularly CDI-related PI-IBS, remains an understudied area. A better understanding of the pathophysiology of PI-IBS is essential to developing more specific and effective management strategies.

Microbiology, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK

Correspondence to Mark H. Wilcox, Microbiology, Old Medical School, Leeds General Infirmary, Leeds LS1 3EX, West Yorkshire, UK. Tel: +44 113 392 6818; fax: +44 113 392 2696; e-mail:

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