Dyspepsia and Gastroparesis
Dyspepsia is the name of another functional gastrointestinal disorder that may occur in the wake of a severe gastrointestinal infection. Symptoms of dyspepsia, which typically occur during or after eating, include nausea, vomiting, bloating, burning pain in the upper mid-abdomen (epigastrium), and filling up quickly while eating (early satiety). Symptoms of dyspepsia have recently been classified into two subgroups by the Rome III group: epigastric pain syndrome (EPS) (burning epigastric pain after eating) and postprandial distress syndrome (PDS) (nausea and bloating after eating). It is estimated that as much as 25% of the world’s population suffers from dyspepsia.
The specific cause of dyspepsia is not known, but individuals who suffer from the condition frequently exhibit any of several abnormalities that may play a role. These include a decreased ability of the stomach to expand with food, delayed gastric emptying, abnormal motility of the small bowel, and infection by Helicobacter pylori (though in this latter group dyspeptic symptoms rarely resolve even after eradication of H. pylori infection).
Recent studies have also demonstrated that, like post-infectious IBS, gastrointestinal infection may also act as a trigger for symptoms of functional dyspepsia. In one study of individuals who had suffered Salmonella infection, one in seven had symptoms of dyspepsia, and one in ten 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 functional dyspepsia was twice as common in those who had suffered gastrointestinal infection than in those who had not. Risk factors for functional dyspepsia were female sex, smoking, pre-existing IBS, anxiety, depression, and having an acute gastrointestinal illness longer than 7 days.
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. Studies of such a possible link are sorely needed.