Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study
http://press.psprings.co.uk/gut/september/gut300220.pdf
http://press.psprings.co.uk/gut/september/gut300220.pdf
Knut-Arne Wensaas,1,2 Nina Langeland,3 Kurt Hanevik,3,4 Kristine Mørch,4,5
Geir Egil Eide,1,6 Guri Rortveit1,2
ABSTRACT
Background Giardia lamblia is a common cause of gastroenteritis worldwide, but there is limited knowledge
about the long-term complications.
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.
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.
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 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 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).
the 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 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.
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.
