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Non-diarrhoeal increased frequency of bowel movements (IFoBM-ND): enterovirus association with the symptoms in children
  1. C Durga Rao1,
  2. P P Maiya1,2,
  3. M Ananda Babu1,3
  1. 1Department of Microbiology & Cell Biology, Indian Institute of Science, Bangalore, Karnataka, India
  2. 2Department of Paediatrics, M. S. R. T. Hospital, and Agadi Hospital, Bangalore, Karnataka, India
  3. 3Department of Paediatrics, R. M. V. Hospital, and Arpita Clinic, Bangalore, Karnataka, India
  1. Correspondence to Professor Durga C Rao; cdr{at}mcbl.iisc.ernet.in

Abstract

Objective Infectious and non-infectious causes are associated with increased frequency of bowel movements (IFoBM). But, a viral aetiology to non-diarrhoeal IFoBM (IFoBM-ND) has not been described. Owing to an accidental infection by an echovirus 19 strain, persistent diarrhoea-associated virus, isolated from a child with persistent diarrhoea, DCR experienced persistent IFoBM-ND with an urgency to pass apparently normal stools more than once each day for about 3 months. A follow-up study was undertaken to determine the prevalence of IFoBM-ND, and association of non-polio enteroviruses (NPEVs) with the symptom in infants from birth to 2 years.

Design A cohort of 140 newborns was followed for 6 months to 2 years from birth for IFoBM-ND. Stool samples collected every 14 days were examined for NPEVs, rotavirus and other viral/bacterial agents for their possible association with IFoBM-ND and diarrhoea.

Results Of 403 NPEV infection episodes among 4545 oral polio vaccine strains-negative stool samples, approximately 29% were associated with IFoBM-ND (15% acute and 14% persistent), including resolution of 74% of constipation episodes, and 18% with diarrhoea, suggesting that about 47% of NPEV infection episodes in children below 2 years of age are associated with gastrointestinal symptoms. About 83% of IFoBM-ND episodes are associated with the NPEV infection and 17% of the episodes are of unknown aetiology.

Conclusions NPEV is the single most frequently detected viral agent in children with IFoBM-ND and its association with the symptom is highly significant, warranting detailed investigations on the role of NPEVs in gastrointestinal diseases.

  • INFECTIOUS DIARRHOEA
  • ENTERIC INFECTIONS
  • SMALL BOWEL MOTILITY
  • NEONATAL GUT
  • MOTILITY DISORDERS

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