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Risks of irritable bowel syndrome in children with infantile urinary tract infection: a 13-year nationwide cohort study
  1. Teck-King Tan1,
  2. Miguel Saps2,
  3. Cheng-Li Lin3,4,
  4. Chang-Ching Wei1,5
  1. 1 Department of Pediatrics, Children’s Hospital, China Medical University Hospital, Taichung, Taiwan
  2. 2 Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Miami Hospital, Miami, Florida, USA
  3. 3 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
  4. 4 Department of Public Health, China Medical University, Taichung, Taiwan
  5. 5 School of Medicine, China Medical University, Taichung, Taiwan
  1. Correspondence to Dr Chang-Ching Wei, School of Medicine, China Medical University, Taichung 40402, Taiwan; weilonger{at}


Early life events play a crucial role in the development of irritable bowel syndrome (IBS). Some evidence suggests the phenomenon of cross-organ sensitization between bladder and colon. Whether urinary tract infection (UTI) during infancy is a risk factor of childhood IBS remains to be elucidated. In this retrospective cohort study, we selected 31 788 infants who had UTI between 2000 and 2011 as a UTI cohort and selected 127 152 infants without UTI as a comparison cohort, matched by age, sex and level of urbanization of living area. Incidence density and HRs with CIs of IBS between UTI and non-UTI cohorts were calculated by the end of 2012. The incidence density of IBS during the study period was 1.52-fold higher in the UTI cohort (95% CI 1.38 to 1.67) compared with the non-UTI cohort (2.05 vs 1.32 per 10 000 person-years). The HR of IBS was slightly higher for boys (1.53; 95% CI 1.34 to 1.73) than for girls (1.50; 95% CI 1.29 to 1.73). The HRs for IBS in children with UTI were greater for those with more UTI-related medical visits/per year (>5 visits, HR 61.3; 95% CI 51.8 to 72.6), with longer length of stay of hospitalization (>7 days, HR 1.75; 95% CI 1.36 to 2.24) and with vesicoureteral reflux (VUR) (HR 1.73; 95% CI 1.35 to 2.22) (p<0.0001, the trend test). Infants with UTI had higher risks of childhood IBS and the risks elevated further with recurrent UTI or UTI with concurrent VUR.

  • irritable bowel syndrome
  • infant
  • urinary tract infection

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  • Contributors T-KT drafted the initial manuscript. C-LL carried out the analysis, reviewed and approved the final manuscript as submitted. MS and C-CW conceptualized and designed the study; coordinated and supervised data collection, critically reviewed the manuscript and approved the final manuscript as submitted.

  • Funding This work was supported by grants from the Ministry of Health and Welfare, Taiwan (MOHW107-TDU-B-212-123004), China Medical University Hospital (DMR-107-044), China Medical University Hospital, Academia Sinica Stroke Biosignature Project (BM10701010021), MOST Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005-), Tseng-Lien Lin Foundation, Taichung, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval The Institutional Review Board of the China Medical University Hospital (CRREC-103-048).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at This work was in part published as an abstract (‘Increased risks of irritable bowel syndrome in children with urinary tract infection during their first year of life: a nationwide population-based cohort study’) at NASPGHAN 2017 Annual Meeting in Las Vegas, Nevada, USA.