GASTROENTEROLOGY ARTICLE OF THE WEEK
October 28, 2004
Spiller RC. Infection, immune function and functional gut disorders. Clin Gastroenterol Hepatol 2004;2:445-55.
1. Postinfective gastroparesis has been described after infection or exposure to
a. CMV
b. EBV
c. Hepatitis C
d. vaccines
e. herpes zoster
2. Postinfective IBS
a. Most have pain rather than diarrhea as their main complaint
b. Only happens after bacterial infections
c. Only a few meet Rome criteria for IBS
d. The risk for developing IBS after an episode of colonic infection is about 10-12
times higher than in non-infected controls.
e. May be associated with impaired bile salt reabsoprtion in some cases.
f. For those who are not crazy, IBS type symptoms may resolve over a 6 year period.
True or False
3. During the later phases of the inflammatory response, macrophage and lymphocyte infiltration may lead to enhanced muscular activity in response to cholinergic stimuli.
4. Dysphagia in the later stages of Chaga’s disease is caused by infiltration of the mucosa with Trypanosome cruzi; eradication of the parasite results in restoration of esophageal peristalsis.
5. Postinfective gastroparesis usually resolves in 1-2 weeks; prokinetics are helpful during the symptomatic period.
6. IBS type symptoms may develop in 33% of UC and 57% of Crohn’s patients who are in remission.
7. Rifaximin therapy for 1 year may be of help for patients with diverticulosis and persistent pain after an episode of diverticulitis.