Cohort Study: Long‐Term Risk and Healthcare Burden of Irritable Bowel Syndrome Following Infection Enteritis in 202,244 Patients

BACKGROUND: Infection enteritis is associated with the development of irritable bowel syndrome (IBS) and functional dyspepsia. AIM: This study aimed to examine the long-term risk of IBS and functional dyspepsia, and associated health care utilisation following infection enteritis. METHODS: We conducted a retrospective cohort study using TriNetX U.S. Network. Adults with infection enteritis were identified and matched to controls, balancing demographics and comorbidities. Primary outcomes were the risk of incident IBS and functional dyspepsia diagnoses at 1, 5, and 10 years. Secondary outcomes were rates of IBS- and functional dyspepsia-related medications, endoscopy, abdominal imaging, and hospitalizations. Pathogen-specific and multivariate analyses were performed to assess variations in IBS risk. RESULTS: After matching, 202,244 patients were identified in each study cohort. At 1 year of follow-up, the infection enteritis cohort had higher rates of IBS (RR = 2.35; 95% CI: 2.14-2.59), functional dyspepsia (RR = 2.02; 95% CI: 1.84-2.22), use of IBS-related medications (RR = 1.29; 95% CI: 1.26-1.31), functional dyspepsia-related medications (RR = 1.56; 95% CI: 1.55-1.59), abdominal imaging (RR = 2.42; 95% CI: 2.29-2.54), and Oesophagogastroduodenoscopy/colonoscopy (RR = 1.57; 95% CI: 1.50-1.65). These risks remained significantly higher in the IE cohort at 5 and 10 years. Salmonella/Shigella (RR = 6.48), and Giardia lamblia (RR = 5.05) had the highest risk of developing incident IBS. CONCLUSION: Infection enteritis was associated with increased risk of IBS and functional dyspepsia, rates of related medication use, and greater healthcare utilisation.