Systematic review with meta-analysis: post-infectious functional dyspepsia

Aliment Pharmacol Ther. 2015 Jan;41(2):177-88. doi: 10.1111/apt.13006. Epub 2014 Oct 27.


Background: The prevalence of functional dyspepsia (FD) following infectious gastroenteritis has not been systematically reviewed.

Aim: To conduct a systematic review and calculate the summary odds ratio (OR) for the development of FD following infectious gastroenteritis, as compared to a control population.

Methods: Published studies in PubMed, EmBASE, and Cochrane Database and abstracts from standard sources were screened for eligible studies. Data from studies meeting inclusion criteria were pooled for meta-analysis.

Results: Nineteen studies were eligible for inclusion. The mean prevalence of FD following acute gastroenteritis (AGE) was 9.55% (FD, n = 909; AGE, n = 9517) in adult populations. The summary OR for the development of post-infectious FD was 2.54 (95% CI = 1.76-3.65) at more than 6 months after AGE, as compared to the prevalence in controls within the same population. This is compared with the summary OR (3.51; 95% CI = 2.05-6.00) for the development of post-infectious irritable bowel syndrome (IBS) in the same population at more than 6 months after AGE. There was significant statistical heterogeneity with an I(2) of 72.8% for the summary OR of post-infectious FD. Several pathogens, including Salmonella spp., Escherichia coli O157, Campylobacter jejuni, Giardia lamblia and Norovirus have been shown to be associated with post-infectious FD symptoms.

Conclusions: Infectious gastroenteritis is associated with an increased risk for subsequent dyspepsia as well as for irritable bowel syndrome. Post-infectious FD and post-infectious irritable bowel syndrome may represent different aspects of the same pathophysiology. Further studies will be needed to determine this.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Bacterial Infections / complications*
  • Bacterial Infections / epidemiology
  • Case-Control Studies
  • Dyspepsia / complications*
  • Dyspepsia / epidemiology*
  • Gastroenteritis / complications*
  • Gastroenteritis / epidemiology
  • Humans
  • Irritable Bowel Syndrome / complications*
  • Irritable Bowel Syndrome / epidemiology*
  • Odds Ratio
  • Prevalence