Dyspepsia and Gastroparesis
Dyspepsia (aka indigestion) is another functional gastrointestinal disorder that may occur in the wake of a severe gastrointestinal infection. Symptoms typically occur during or after eating, including uncomfortable fullness after eating (early satiety) and bothersome epigastric burning or pain, without evidence of structural disease (i.e. normal upper endoscopy) to explain the symptoms. Dyspepsia has been classified into two subgroups by the Rome IV group: (1) postprandial distress syndrome; and (2) epigastric pain syndrome. It is estimated that as much as 25% of the world’s population suffers from dyspepsia.
Recent studies have also demonstrated that, like post-infectious IBS, gastrointestinal infection may also act as a trigger for symptoms of functional dyspepsia (FD). In one study of individuals who had suffered Salmonella infection, 1 in 7 had symptoms of dyspepsia and 1 in 10 had symptoms of IBS. In another, more comprehensive study, physicians following thousands of individuals infected by E. coli O157:H7 in a drinking water outbreak found that FD was twice as common in those who had suffered gastrointestinal infection than in those who had not. Risk factors for FD were female sex, smoking, pre-existing IBS, anxiety, depression, and having an acute gastrointestinal illness longer than 7 days. A meta-analysis found the mean prevalence of FD after acute gastroenteritis was 9.55% in adults. Pathogens associated with FD included Salmonella, Shiga-toxin producing E. coli O157:H7; Campylobacter jejuni, Giardia lamblia, and Norovirus.
Gastroparesis is a condition in which stomach emptying is delayed, resulting in symptoms of nausea, vomiting, early satiety, and weight loss. It is most commonly associated with diabetes, but sporadic cases can occur. There appears to be a relationship with viral gastroenteritis, as studies have shown development after rotavirus infection in children. There are no studies linking gastroparesis to bacterial infection, but a link may exist.