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• W4231540334 abstract "We are grateful to Drs Wang and Chang for their thoughtful review of our study of the 8-year prognosis of postinfectious irritable bowel syndrome (IBS) in the Walkerton Health Study cohort. The outbreak of acute gastroenteritis in this community in 2000 was a public health tragedy, but has provided valuable insight into the natural history and long-term health consequences of acute gastroenteritis.There are substantial logistic and methodological challenges in undertaking a study of this size and duration, and these are correctly identified by Drs Wang and Chang. We agree that recall bias can misclassify cases and controls, but were reassured in preliminary analyses that our 2 categories of exposure (self-reported vs. clinically suspected) did show a gradient of effect, with higher rates of postinfectious IBS and other health sequelae in the latter (Can J Public Health 2005;96:125–130).Wang and Chang point out correctly that Rome II criteria are more restrictive and would likely have generated lower estimates of prevalence than those reported in our analysis. We use Rome I to err intentionally on the side of being overly inclusive, as Rome criteria were developed for identification of sporadic functional disorders, and it is entirely plausible that post-infectious symptoms cluster differently. Detailed analyses of individual symptoms in this cohort, including pain, are now underway.It is correct, that our diagnoses of IBS relied on self-reported symptoms, and that primary health records were not reassessed through the duration of the study. However we did ask returning participants about specific new gastrointestinal diagnoses at each visit, including inflammatory bowel disease. We have reported that there was no statistically significant increase in the incidence of inflammatory bowel disease after the outbreak (Gastroenterology 2010;138:S145), but even the Walkerton Health Study may be of insufficient size and duration to detect such an effect.It is our sincere hope that no community suffers the disaster experienced by the citizens of Walkerton. However we remain grateful to their contributions to this analysis, which have improved substantially our understanding of postinfectious functional disorders. We are grateful to Drs Wang and Chang for their thoughtful review of our study of the 8-year prognosis of postinfectious irritable bowel syndrome (IBS) in the Walkerton Health Study cohort. The outbreak of acute gastroenteritis in this community in 2000 was a public health tragedy, but has provided valuable insight into the natural history and long-term health consequences of acute gastroenteritis. There are substantial logistic and methodological challenges in undertaking a study of this size and duration, and these are correctly identified by Drs Wang and Chang. We agree that recall bias can misclassify cases and controls, but were reassured in preliminary analyses that our 2 categories of exposure (self-reported vs. clinically suspected) did show a gradient of effect, with higher rates of postinfectious IBS and other health sequelae in the latter (Can J Public Health 2005;96:125–130). Wang and Chang point out correctly that Rome II criteria are more restrictive and would likely have generated lower estimates of prevalence than those reported in our analysis. We use Rome I to err intentionally on the side of being overly inclusive, as Rome criteria were developed for identification of sporadic functional disorders, and it is entirely plausible that post-infectious symptoms cluster differently. Detailed analyses of individual symptoms in this cohort, including pain, are now underway. It is correct, that our diagnoses of IBS relied on self-reported symptoms, and that primary health records were not reassessed through the duration of the study. However we did ask returning participants about specific new gastrointestinal diagnoses at each visit, including inflammatory bowel disease. We have reported that there was no statistically significant increase in the incidence of inflammatory bowel disease after the outbreak (Gastroenterology 2010;138:S145), but even the Walkerton Health Study may be of insufficient size and duration to detect such an effect. It is our sincere hope that no community suffers the disaster experienced by the citizens of Walkerton. However we remain grateful to their contributions to this analysis, which have improved substantially our understanding of postinfectious functional disorders. The Walkerton Outbreak Revisited at Year 8: Predictors, Prevalence, and Prognosis of Postinfectious Irritable Bowel SyndromeGastroenterologyVol. 140Issue 2PreviewMarshall JK, Thabane M, Garg AX, et al; Walkerton Health Study Investigators. Eight year prognosis of postinfectious irritable bowel syndrome following waterborne bacterial dysentery. Gut 2010;59:605–611. Full-Text PDF" @default.
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• W4231540334 date "2011-02-01" @default.
• W4231540334 modified "2023-10-18" @default.
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• W4231540334 doi "https://doi.org/10.1053/j.gastro.2010.12.031" @default.
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