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Stomach bug giardia linked to IBS and chronic fatigue syndrome
      10/06/11 07:02 PM
HeatherAdministrator

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Gut doi:10.1136/gutjnl-2011-300220


Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study

Knut-Arne Wensaas1,2,
Nina Langeland3,
Kurt Hanevik3,4,
Kristine Mørch4,5,
Geir Egil Eide1,6,
Guri Rortveit1,2

+ Author Affiliations

1Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
2Research Unit for General Practice, Uni Health, Bergen, Norway
3Institute of Medicine, University of Bergen, Bergen, Norway
4National Centre for Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway
5Department of Medicine, Unit for Infectious Diseases, Haukeland University Hospital, Bergen, Norway
6Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway

Correspondence to Dr Knut-Arne Wensaas, Research Unit for General Practice, Uni Health, Kalfarveien 31, N-5018 Bergen, Norway; knut-arne.wensaas@uni.no

Contributors KAW, NL, KH, KM and GR conceived the study, and all authors designed it. GR acquired funding and supervised the study. GEE and GR provided guidance on statistical methods. KAW did all statistical analyses, and wrote the first draft of the manuscript. All authors contributed to the interpretation of the results, revision of the manuscript and approved the final version. KAW is the guarantor.

Revised 22 June 2011
Accepted 27 June 2011
Published Online First 12 September 2011

Abstract

Background Giardia lamblia is a common cause of gastroenteritis worldwide, but there is limited knowledge about the long-term complications.

Objective To estimate the relative risk of irritable bowel syndrome (IBS) and chronic fatigue 3 years after acute giardiasis.

Design Controlled historic cohort study with 3 years' follow-up. Data collected by mailed questionnaire.

Setting Waterborne outbreak of giardiasis in the city of Bergen, Norway.

Participants 817 patients exposed to Giardia lamblia infection verified by detection of cysts in stool samples and 1128 matched controls.

Main outcome measures IBS and chronic fatigue.

Results The prevalence of IBS in the exposed group was 46.1%, compared with 14.0% in the control group, and the adjusted RR=3.4 (95% CI 2.9 to 3.8). Chronic fatigue was reported by 46.1% of the exposed group and 12.0% of the controls, the adjusted RR was 4.0 (95% CI 3.5 to 4.5). IBS and chronic fatigue were associated and the RR for the exposed group of having a combination of the two outcomes was 6.8 (95% CI 5.3 to 8.5). The RR was also increased for having just one of the two syndromes, 1.8 for IBS (95% CI 1.4 to 2.3) and 2.2 for chronic fatigue (95% CI 1.7 to 2.8).

Conclusions Infection with Giardia lamblia in a non-endemic area was associated with a high prevalence of IBS and chronic fatigue 3 years after acute illness, and the risk was significantly higher than in the control group. This shows that the potential consequences of giardiasis are more serious than previously known. Further studies are needed, especially in areas where giardiasis is endemic.

http://gut.bmj.com/content/early/2011/08/31/gutjnl-2011-300220.abstract


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