IBS After C difficile Infection May Be Misdiagnosed as C difficile Recurrence

Symptoms suggestive of irritable bowel syndrome (IBS) following the resolution of Clostridioides difficile infection (CDI) were found to be prevalent among patients referred to a clinic for recurrent CDI, according to study findings presented at IDWeek, held from October 19 to 23, 2022, in Washington, DC.

Researchers conducted a study using data captured from the electronic health records of 67 patients who were referred to a clinic for consideration of fecal microbiota transplantation between March 2020 and July 2021.

The mean patient age was 64 (range, 21-93) years, 51 (76%) patients were women, and the majority (54%) were referred to the clinic by a primary care provider. Of note, 25 (67%) patients were receiving treatment for recurrent CDI despite documented C difficile positivity.

The researchers found that 32.8% of patients initially referred to the clinic for recurrent CDI had symptoms suggestive of post-CDI IBS. Compared with patients with confirmed CDI, those post-CDI IBS symptoms were significantly more likely to be younger (P =.03), have fewer comorbidities (P <.001), and have a history of anxiety (P =.03).

“Our findings suggested that post-CDI IBS is prevalent, can be misdiagnosed as CDI recurrence, and may lead to inappropriate use of anti-C. difficile agents or interventions,” the researchers concluded.