Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: his

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

http://press.psprings.co.uk/gut/september/gut300220.pdf

Knut-Arne Wensaas,1,2 Nina Langeland,3 Kurt Hanevik,3,4 e Mørch,4,5Geir Egil Eide,1,6 Guri Rortveit1,2

ABSTRACTBackground Giardia lamblia is a common cause of gastroenteritis worldwide, but there is limited knowledgeabout the long-term complications.

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

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 samplesand 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, andthe adjusted RR¼3.4 (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 RRfor the exposed group of having a combination of the two outcomes was 6.8 (95% CI 5.3 to 8.5). The RR wasalso 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 highprevalence of IBS and chronic fatigue 3 years after acute illness, and the risk was significantly higher than in thecontrol 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.