Postinfectious irritable bowel syndrom

The functional bowel disorders including the irritable bowel syndrome are the final diagnosis in significant proportion of gastroenterological

patients. The irritable bowel syndrome is characterised by changes of bowel habits with abdominal dyscomfort or abdominal

pain. The pathophysiology of irritable bowel syndrome is still not completely understood. Recently, it has been proved that in 20–30 %

of patients with irritable bowel syndrome the infectious gastroenteritis preceded the clinical manifestation of the bowel functional

disoorder. The bacterial infections (campylobacteriosis, shigelosis and salmonelosis) are considered as the most important causes for

irritable bowel syndrome development. The gastrointestinal infections might induced the abnormal motility pattern which includes

the pathologic gastro-colic reflex and a visceral hyperalgesia. It has been stressed, that coincidental psychiatric illness eg depression or

anxiety and panic neurosis are very important permisive factors for irritable bowel syndrome development.

Therapy of irritable bowel syndrome has to be complex, and symptomatic. Dietary and life style arrangement are very important. The

drug therapy include antidiarrheal agents (diphenyloxylate, loperamide, cholestyramine), tricyclic antidepressants, neuroleptics, and

also musculotropic antispasmodics. Especially in the postinfectious irritable bowel syndrome the long therm therapy with cholestiramine

has been shown as a effective therapy.

Keywords: irritable bowel syndrome, functional bowel disorders, gastrointestinal infections.