Post-infectious Irritable Bowel Syndrome: an opportunity for prebiotics as an adjunct therapy of oral rehydration salts/solutions

Irritable bowel syndrome (IBS) is a persistent and relapsing functional gastrointestinal disorder. The Rome III criteria in children and adults are required in diagnosing IBS. The criteria include recent abdominal pain or discomfort present in three or more days/months with two or more of the following changes related to bowel movements: symptoms improving with defecation; excretion frequency change with onset of symptoms; or changes in stool form (hardness) with onset of symptoms [1]. The clinical presentation of constipation, diarrhea, or a combination, constitutes the different subtypes: IBS with constipation (IBS-C), with diarrhea (IBS-D), and mixed (IBS-M). The distribution of patients is about equal among the subtypes [2]. This syndrome poses a significant social problem and clinical challenge, because it is one of the most frequent alimentary tract illnesses reported by patients, young and old, and also the most common reason for referrals [1,3]. The clinical challenge rises from the fact that its diagnosis is based on symptomatology in the absence of organic disease. This review will emphasize the clinical importance of Post-Infectious IBS (PI-IBS) in contributing to IBS prevalence and highlight the alterations of the intestinal microbiota observed in IBS. Based on the microbiota changes, the implementation of prebiotics as an adjunct therapy of ORS may be a preventive measure of IBS in susceptible individuals.