The Don Julio Salmonella outbreak, which has claimed more than 59 victims–possibly hundreds–will cause many to develop a condition called post-infectious irritable bowel syndrome (IBS). Here is some additional information for any of the victims who do, in fact, develop this long-term, and in some cases permanent, condition:
Diagnosis of IBS:
Clinicians diagnose IBS by identifying typical symptoms, taking a thorough history and doing a complete physical examination, and testing blood samples for other potential causes of symptoms. Stool tests are also indicated as a means of testing for minute amounts of blood in the stools (occult blood), and sometimes to exclude active infection as the cause of symptoms. In some patients, examining the colon with colonoscopy may be indicated, particularly for anyone 50 or over. The most important organic diseases that can have similar symptoms are inflammatory bowel disease, colon cancer, celiac disease, and in women, ovarian cancer, which can initially present simply as abdominal bloating.
Signs and symptoms that suggest organic disease, rather than IBS, are onset of symptoms over age 50, short duration of symptoms, blood in the stools, symptoms waking one at night, unintentional weight loss, anemia, fever, mass on rectal or abdominal exam, symptoms associated with recent antibiotics, and a family history of organic GI disease (such as colon cancer, inflammatory bowel disease, and celiac disease). If one or more of these features is present, further clinical investigation is indicated.
Treatment of IBS:
Treatment of IBS varies from person to person, and case to case. They include, where appropriate, changes in lifestyle, such as eating regular meals; changes in diet, such as increasing fiber in those with constipation; and eliminating trigger foods such as fructose and non-absorbable sugars, which can cause diarrhea and bloating. Over the counter medications can be used to decrease diarrhea (loperamide) or improve constipation (soluble or insoluble fiber, laxatives).
Antispasmodics can help with pain, but narcotics are not a good therapy for IBS symptoms because they can alter gastrointestinal tract motility, affect mental function, and cause dependency. For a small number of patients with severe and refractory symptoms, especially pain, low dose antidepressants can be very effective. Probiotics have been helpful for some, though studies on probiotics in the setting of IBS are limited. In certain trials, benefits have also been seen with hypnotherapy, acupuncture, and psychotherapy.