What complications can Salmonella cause?

Reactivate Arthritis

Reactive arthritis, formerly known as Reiter’s syndrome, is inflammation of one or more joints following a local infection in an area distant from the affected joint. The main site of infection is the gastrointestinal tract. Reactive arthritis may develop after an infection, meaning the infection may not be active at the time of diagnosis.Various bacteria, including salmonellacan cause reactive arthritis.(1) Although the resulting joint pain and inflammation can completely subside over time, permanent joint damage can occur.(2)

Symptoms of reactive arthritis include pain and swelling in the knees, ankles, feet, and heels. Rarely, the upper limbs may be affected, including the wrists, elbows, and fingers. Tendonitis (inflammation of the tendon) or enthesitis (inflammation of the tendon attachment to the bone) may occur. Other symptoms may include prostatitis, cervicitis, urethritis (inflammation of the prostate, cervix, or urethra), conjunctivitis (inflammation of the lining of the eyelids), or uveitis (inflammation of the inner eye). Ulcers and rashes are less common. Symptoms can range from mild to severe, can occur anywhere from three days to six weeks after a previous infection, and may involve one or more joints, but usually six or less. Although most cases recover within a few months, some cases continue to have complications for years. Treatment focuses on relieving symptoms.(3)

irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract. The hallmark symptoms of IBS are abdominal pain and a change in bowel habits, from constipation to diarrhea or alternating between diarrhea and constipation. Abdominal pain is usually crampy but may vary in nature and location. For some patients, having a bowel movement relieves pain, but for others, having a bowel movement may worsen the pain. Other symptoms may include bloating, straining during bowel movements, and a feeling of incomplete bowel movements.

The observation that gastrointestinal infections may contribute to the onset of IBS symptoms dates back to the 1950s. The mechanisms are unclear but include changes in the microbiome, use of antibiotics to treat infections, and an increase in enteroendocrine cells.

Another consequence of infectious gastroenteritis is the disruption of normal intestinal flora. Studies of postinfectious IBS have provided etiological insights into the pathogenesis of IBS. It is well documented that after infectious gastroenteritis, more than 10% of affected individuals go on to develop post-infectious irritable bowel syndrome (IBS).(4) The risk of irritable bowel syndrome appears to be greater after infection with bacterial gastroenteritis than with viral gastroenteritis.

(1) look “Reactivating Arthritis.” Questions and answers about. Np,nd network. November 12, 2015.

(2) ID.

(3) “Reactivating Arthritis.” National Institute of Arthritis and Musculoskeletal and Skin Diseases, October 2016. URL: https://www.niams.nih.gov/health-topics/reactive-arthritis.

(4) Ng, QX, Soh, A., Loke, W., Lim, DY, and Yeo, WS (2018). The role of inflammation in irritable bowel syndrome (IBS). Journal of Inflammation Research, eleven, 345–349. https://doi.org/10.2147/JIR.S174982

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