Childhood Deprivation: An Antecedent of the Irritable Bowel Syndrome

Ig, Hislop

doi:10.5694/j.1326-5377.1979.tb126963.x

Cited by 63 publications

(35 citation statements)

References 16 publications

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“…The prevalence of specific types of abuse is similar to previously reported prevalence numbers in IBS patients, including the prevalence of a history of sexual abuse 15 and the prevalence of disturbances in the child-caregiver relationship. 16 Our study found that 47% of IBS patients experienced divorce, separation, or death of parents (vs. 36% in HCs, p=0.004) and 18% had parents or primary caregivers with alcoholism or drug abuse (vs. 13% in HCs, p=0.06). Additionally, 35% of patients in our study stated that their parents or caretakers often failed to understand them or their needs compared to 14% of HCs (p<0.001).…”

Section: Discussionmentioning

confidence: 59%

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Association Between Early Adverse Life Events and Irritable Bowel Syndrome

Bradford¹,

Shih²,

Videlock³

et al. 2012

Clinical Gastroenterology and Hepatology

266

237

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Background & Aims Although childhood and adult abuse are more prevalent among patients with irritable bowel syndrome (IBS) than healthy individuals (controls), other types of early adverse life events (EALs) have not been well characterized. We investigated whether different types of EALs, before an age of 18 years, are more prevalent among patients with IBS, and the effects of gender and non-gastrointestinal symptoms on the relationship between EALs and IBS. Methods EALs were evaluated in 294 IBS patients (79% women) and 435 controls (77% women) using the early trauma inventory self report form, which delineates sub-categories of general trauma and physical, emotional, and sexual abuse. Validated questionnaires assessed gastrointestinal, psychological, and somatic symptoms. Results Compared to controls, IBS patients reported a higher prevalence of general trauma (78.5% vs 62.3%), physical punishment (60.6% vs 49.2%), emotional abuse (54.9% vs 27.0%), and sexual events (31.2% vs 17.9%) (all P’s <.001). These significant differences were mainly observed in women. Of the EAL domains, emotional abuse was the strongest predictor of IBS (P<.001). Eight of the 27 EAL items were significant (P<.001) and increased the odds of having IBS by 108%–305%. Although EAL and psychological variables were related, EALs had an independent association with IBS (P=.04). Conclusion Various types of EALs are associated with development of IBS—particularly among women. Psychological distress and somatic symptoms might contribute to this relationship. When appropriate, EALs and non-gastrointestinal symptoms should be assessed in IBS patients.

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Section: Discussionmentioning

confidence: 59%

“…15 EALs other than abuse have not been studied extensively in IBS patients. In 1979, Hislop 16 reported that 31% of IBS patients had experienced parental death, divorce or separation and 61% reported unsatisfactory relationships with or between their parents before the age of 15, but there was no comparison to a control group.…”

Section: Introductionmentioning

confidence: 99%

Association Between Early Adverse Life Events and Irritable Bowel Syndrome

Bradford¹,

Shih²,

Videlock³

et al. 2012

Clinical Gastroenterology and Hepatology

266

237

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“…Although the psychological disorders can occur at the same time as IBS, they often precede the onset, suggesting that they should not be considered as a response to IBS (18). Early life risk factors for the development of IBS include various forms of childhood adversity, such as increased socioeconomic stress during childhood (32), childhood physical and sexual abuse (15,33–38), low birth weight (39), and poor parental relationships such as losing one parent through death (40). This exposure to early life stress may result in persistence of childhood psychological distress into adulthood and therefore decrease the relative impact of current IBS symptoms on current psychological state.…”

Section: Discussionmentioning

confidence: 99%

“…This exposure to early life stress may result in persistence of childhood psychological distress into adulthood and therefore decrease the relative impact of current IBS symptoms on current psychological state. In IBD patients, there are much less data suggesting a role for early life psychological adversity, and more data showing physical risk and protective factors in IBD (38–40). However, it is important to note that few studies have systematically examined hypotheses of early psychological stress in IBD.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal and Psychological Mediators of Health-Related Quality of Life in IBS and IBD: A Structural Equation Modeling Analysis

Naliboff¹,

Kim²,

Bolus³

et al. 2012

American Journal of Gastroenterology

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Objective Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are chronic gastrointestinal (GI) syndromes in which both GI and psychological symptoms have been shown to negatively impact health-related quality of life (HRQOL). The objective of this study was to use structural equation modeling (SEM) to characterize the interrelationships among HRQOL, GI, and psychological symptoms to improve our understanding of the illness processes in both conditions. Methods Study participants included 564 Rome positive IBS patients and 126 IBD patients diagnosed via endoscopic and / or tissue confirmation. All patients completed questionnaires to assess bowel symptoms, psychological symptoms (SCL-90R), and HRQOL (SF-36). SEM with its two components of confirmatory analyses and structural modeling were applied to determine the relationships between GI and psychological symptoms and HRQOL within the IBS and IBD groups. Results For both IBD and IBS, psychological distress was found to have a stronger direct effect on HRQOL(−0.51 and −0.48 for IBS and IBD, respectively) than GI symptoms (−0.25 and −0.28). The impact of GI symptoms on psychological distress was stronger in IBD compared with IBS (0.43 vs. 0.22; P <0.05). The indirect effect of GI symptoms on HRQOL operating through psychological distress was significantly higher in IBD than IBS (−0.21 vs. −0.11; P <0.05). Conclusions Psychological distress is less dependent on GI symptom severity in IBS compared with IBD even though the degree that psychological distress impacts HRQOL is similar. The findings emphasize the importance of addressing psychological symptoms in both syndromes.

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“…10 Concerning IBS, several reports indicate that loss and separation in the current family in childhood may contribute to the development of IBS in adults. 11 12 It has recently been shown in rats that neonatal maternal deprivation triggers long term hypersensitivity to rectal distension, 13 14 which corresponds to the main physiopathological characteristic of IBS in humans. 15 Recently, Coelho and colleagues 16 reported that hypersensitivity to rectal distension may be related to elevated colonic paracellular permeability in rats; elevated colonic paracellular permeability induced by activation of colonic proteinase activated receptor 2 has been found to be associated with visceral hyperalgesia to rectal distension.…”

mentioning

confidence: 99%

Neonatal maternal deprivation triggers long term alterations in colonic epithelial barrier and mucosal immunity in rats

Barreau¹

2004

Gut

213

169

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Background: Stressful events in the early period of life (for example, maternal deprivation) have been shown to modify adult immune and gastrointestinal tract functions. The present study aimed to establish whether maternal deprivation affects colonic epithelial barrier and the development of an experimental colitis in adult rats. Methods: Male Wistar rat pups were separated during postnatal days 2-14 or left undisturbed with their dam. At 12 weeks of age, we assessed colonic paracellular permeability, bacterial translocation, myeloperoxidase (MPO) activity, mucosal mast cell density, cytokine (interleukin (IL)-1b, IL-2, IL-4, IL-10, and interferon c (IFN-c)) mRNA expression, and macroscopic damage. Total gut permeability, MPO activity, and macroscopic damage were also assessed four days after intracolonic administration of 2,4,6-trinitrobenzenesulphonic acid (TNBS). Results: Maternal deprivation triggered a significant increase in colonic permeability associated with bacterial translocation into the mesenteric lymph nodes, liver, and spleen. These alterations were associated with some macroscopic damage and an increase in colonic MPO activity, mucosal mast cell density, and cytokine mRNA expression. Intracolonic infusion of TNBS induced a significantly higher inflammatory reaction in separated animals, as judged by enhanced MPO colonic levels, total gut permeability, and macroscopic lesions. Conclusions: Maternal deprivation promotes long term alterations in the colonic epithelial barrier associated with an exaggerated immune response to an external immune stimulus. This suggests a role for early psychological factors in the regulation of colonic mucosal barrier in later life.

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Childhood Deprivation: An Antecedent of the Irritable Bowel Syndrome

Cited by 63 publications

References 16 publications

Association Between Early Adverse Life Events and Irritable Bowel Syndrome

Association Between Early Adverse Life Events and Irritable Bowel Syndrome

Gastrointestinal and Psychological Mediators of Health-Related Quality of Life in IBS and IBD: A Structural Equation Modeling Analysis

Neonatal maternal deprivation triggers long term alterations in colonic epithelial barrier and mucosal immunity in rats

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