What is Post Infectious IBS?

Posted by Dr. Robin Terranella

Are you thinking you might have symptoms of post infectious IBS? Did you know that IBS is often triggered by some previous infection in the intestines? We are going to discuss what post infectious IBS is, what are the mechanisms involved that trigger this process, and what prevents the body from getting back to normal quickly. These are the things you need to understand to improve your digestion and health.

If this is something that interests you keep reading we're going to get into the details.

Post Infections IBS Explained

What is post infectious IBS? Basically it's just what it sounds like. It is IBS or irritable bowel syndrome following some kind of infection. Not just any

infection, though. It's a chronic infection in the small intestine following something like food poisoning from a bad restaurant, Norovirus, maybe someone was sick themselves and it got into the food, travelers diarrhea, the flu, etc. All these can lead to this post infectious state.

Basically what happens is the bugs get into the digestive tract and trigger

inflammation. For multiple reasons, some people don't get over the infection. They don't get over it and this is the key that leads to these

chronic digestive symptoms.

It seems that some people are more susceptible to this problem too. So that, it's not just the infection itself but it's infection on top of a susceptible

individual. A lot of people have had gastroenteritis or traveler's diarrhea and they get over it just fine. For some people it takes just a few weeks to get over this. Other times it takes months or years and sometimes people don't get over at all. The basic issue is with inflammation. The infection triggers the inflammation in the body and the body is not able to recover from this inflammation.

To better understand this we want to look at some of the mechanisms involved. This will lead to a better understanding that will help you can get over it as quickly as possible. Let's look a little deeper at what is preventing the digestive tract from getting back to normal quickly.

Post Infectious IBS and Recovery Gone Wrong

When we have inflammation anywhere in our body it is there to first prevent further damage and then repair any damaged tissues. The typical process for inflammation is that there is some insult to the tissues that creates the inflammatory cascade. The cascade of events starts with the immune system getting triggered to come in and wall off the area. The next event is to work on repair of the involved tissue.

cartoon of post infectious IBS

Built within this cascade of events is a shutoff valve or down regulation of the repair process. You see during repair process, the white blood cells are breaking down and getting rid of the old damaged tissues. If it goes on too long the white blood cells can damage some of the new repaired tissues. This can re-trigger the same cascade again. This is what happens with chronic inflammation wether it is in your intestines or your joints. The natural shut off processes or down regulation is not getting triggered. This is the current thinking on why chronic inflammation occurs after the trigger is removed.

Of course if there is some chronic pathology still present triggering the inflammation that would be a problem too. Like with a knee injury that does not get proper time to heal from continued running on the knee.

So instead of inflammation, repair, and then shut off, the process becomes more circular. You have inflammation, repair, inflammation, repair and inflammation again. When you have chronic inflammation in the intestines what happens is the gap junctions (spaces between the cells) open up. The cells in the intestines are connected by gap junction protein. The proteins allow the cells to move away from one another or further apart.

When you have inflammation the proteins open up and allow water from inside the body to come into the intestines through the gap junctions. This is helpful because this process will push out the offending agent that is triggering the inflammation. This is why many of these infections cause diarrhea. When your immune system detects inflammation in the intestines it triggers the gap junctions to open up.

When the inflammation is chronic these gap junctions get broken down and degraded. This can be a problem if they don't get repaired properly and they stay open. This allows for other foreign invaders to try to enter into the body. This then triggers more inflammation. This process of broken and poorly repaired gap junctions is referred to as Leaky Gut Syndrome.

Learn More About Leaky Gut

So basically when you have this chronic inflammation you have chronic leaky gut and you need to repair that process first. You also need to know what the trigger was to begin with and make sure that trigger has been taken care. The moral of the story is the chronic inflammation is causing post infectious IBS because your body hasn't really recovered properly.

Post Infectious IBS and Your Microbiome

The other thing that can occur with post infectious IBS is disruption in your microbiome. The good bacteria that sit in your digestive tract are close to the surface of the intestinal cells. These can get thrown out of balance in a few different ways.

So the first thing is remember that most of the good bacteria are in the large intestines not the small intestines. When you get enteritis it could be in the small or large intestines but typically in the small intestines. The reason the microbiome gets imbalanced from this is because some of the good bacteria got swept away by the ongoing diarrhea. Also they may be having trouble repopulating the colon because of diet changes made since the infection. These good bacteria act as part of the anti-inflammatory signals to the immune system and the digestive cells. When there's imbalance there that can also re-trigger or prolong the inflammation.

Sometimes people are just nutrient deficient and certain things that aren't allowing these cells to recover or that gap junction proteins are not able to recover properly because of nutrient deficiencies.

If you have IBS or post infectious IBS and struggle to get your digestion back to normal, click on the link below for a customized plan to improve your digestion naturally.