Chronic Complications After Travelers' Diarrhea

Most people who develop an episode of travelers' diarrhea (TD) experience self‐limiting illness with approximately 1 day of disability1 without further medical complications. In this edition of the Journal, Connor and Riddle describe the available literature related to three well‐defined complications of enteric infection including reactive arthritis (ReA), Guillain–Barre syndrome (GBS), and post‐infectious irritable bowel syndrome (PI‐IBS).2 The review by Connor and Riddle focuses on these complications that have occurred following enteric infection of non‐travelers. We do not know if these complications of enteric infection are seen with any importance in returning travelers. My comments will also relate to these post‐enteric infection complications largely of non‐travelers.ReA or GBS develop from 1 to 4 weeks after enteric infection consistent with an immune disorder, while it may take months for PI‐IBS to evolve. Of the three medical complications, the pathogenesis of GBS is best understood. Host antibodies directed at an infecting strain of Campylobacter secondarily react to central nervous system gangliocides causing … Corresponding Author: Herbert L. DuPont, MD, MACP, University of Texas School of Public Health, 1200 Herman Pressler, Suite 733, Houston, TX 77030, USA. E‐mail: herbert.l.dupont{at}uth.tmc.edu