Emotional upset determines the persistence of gastroenteritis after the infection has gone

About 10% of people develop persistent diarrhoea after an attack of gastroenteritis even though there is no evidence of an infective agent. Studies conducted by Dr Kok-Ann Gwee in collaboration with Drs Mike McKendrick and Professor Steve Collins from McMaster University in Ontario revealed that anxiety, depression and life trauma occurring at the time of the original infection predicted persistence of symptoms and inflammation. It was as if the gastroenteritis were recruited to express unresolved emotional issues. Further studies showed that the same principle applied to surgical trauma such as hysterectomy, and to infections in other parts of the body. Symptoms caused by psychological stress were likely to persist as long as the stress persisted.

  1. Gwee, K.A., Graham, J.C., McKendrick, M.W., Collins, S.M., Marshall, J.S., Walters, S.J., Read, N.W. (1996). Psychometric scores and persistence of Irritable Bowel after infectious diarrhoea. The Lancet. Jan 20;347(8995):150-3.
  2. Gwee KA, Leong YL, Graham C, McKendrick M, Collins SM, Walters SH. Underwood JE. Read NW. (1999). The role of psychological and biological factors in post infective gut dysfunction. Gut. 44: 400-406.
  3. Gwee KA. Collins SF and Read NW. (2000) Increased rectal mucosal expression of interleukin lB as a marker of inflammatory pathogenesis in recently acquired post infectious IBS. 2000.
  4. Lewis IM, Read NW, McKendrick MW (2003). Prospective study of factors influencing the persistence of symptoms in hospitalised patients with acute infection. Journal of Psychosomatic Research. 2003; 54 (4): 307-311