Postinfectious Chronic Gut Dysfunction: From Bench to Bedside

The relationship between acute infectious gastroenteritis and the subsequent development of chronic gastrointestinal dysfunction has been established on the basis of clinical observations, prospective and epidemiological clinical studies, and from animal models. Clinically, two specific syndromes have been identified: postinfectious irritable bowel syndrome and postinfectious functional dyspepsia. These syndromes may develop in up to 30% of patients with gastroenteritis and both host and microbial risk factors have been identified. Initially, these conditions were considered to be short lived but recent epidemiological data indicate that they can persist for at least 8 years or more. Studies on animal models as well as in patients have identified changes in intestinal barrier and motor functions, as well as evidence of immune activation and low-grade inflammation. These findings prompt ongoing research into the role of anti-inflammatory medication treatment for these conditions. In addition, current research examines possible changes in the intestinal microbiota as a basis for the low-grade inflammation and symptom generation. The long-term consequences of these syndromes remain to be determined.