Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction.

Abstract

A standardised inventory of stressful life events and a bowel symptom questionnaire were administered at three month intervals for one year to 383 women who were unselected with respect to bowel symptoms. A NEO Personality Inventory was given initially to assess neuroticism. Subjects who satisfied restrictive diagnostic criteria for irritable bowel syndrome were compared with those who complained of abdominal pain plus altered bowel habits but who did not meet restrictive diagnostic criteria (functional bowel disorder) and with controls without bowel dysfunction. The irritable bowel group showed significantly higher levels of stress than the other two groups even when the confounding effects of neuroticism were statistically controlled for. Time lagged correlations showed that stress in one three month interval was significantly correlated with bowel symptoms in the subsequent three month interval for all groups. The slope of the regression line relating stress to bowel symptoms was significantly steeper for the irritable bowel group than for the other two groups at three and six months, suggesting that subjects with irritable bowel syndrome show a greater reactivity to stress. Stress scores were also significantly correlated with the number of disability days and the number of medical clinic visits for bowel symptoms.

Association between psychological distress and gastrointestinal symptoms in diabetes mellitus

“…B�tzer et al [19] sho�e� an in�rease� �re�alen�e of �iar-rhea or �onsti�ation (15���%)�, bloating (12��3%)� an� earl� satiet� (54%)� in �iabeti� �atients�� E�en the o�� ratios = 3��77)� �ere signifi�antl� �ifferent in �iabeti� �e-= 3��77)� �ere signifi�antl� �ifferent in �iabeti� �e-3��77)� �ere signifi�antl� �ifferent in �iabeti� �e-3��77)� �ere signifi�antl� �ifferent in �iabeti� �e-�resse� �atients fro� health� subje�ts�� These �ata sho� that gastrointestinal s���to�s �ere �ore �losel� relate� to �s��hiatri� �isturban�es�� On the other han�, it is also �ossible that un�leasant GI s���to�s lea� to in�rease� anxiet� an� �e�ression�� Even so, the studied diabetic patients were significantl� �ore anxious �ith the GI s���to�s of anal blo�kage (53��3% vs 35��5%)�, heartburn (34���% vs 17��7%)�, loose� �ater� stools (2���2% vs 11��3%)� an� �ost�ran�ial illness (2���2% vs 12��9%)� an� the� �ere signifi�antl� �ifferent fro� their �ounter�arts�� It is �o�u�ente� that �s��ho-logi�al �ulnerabilit� is asso�iate� �ith a �oorer out�o�e for �eo�le �ith �hroni� GI s���to�s [22] �� In stu�ie� �ia-beti� �atients �ith se�ere anxiet�, o�� ratios re�eale� that loose��ater� stools (OR = 2��79)�, heart burn (OR = 2��45)�, = 2��79)�, heart burn (OR = 2��45)�, = 2��79)�, heart burn (OR = 2��45)�, 2��79)�, heart burn (OR = 2��45)�, 2��79)�, heart burn (OR = 2��45)�, = 2��45)�, = 2��45)�, 2��45)�, 2��45)�, �ost�ran�ial fullness (OR = 2��39)�, anal blo�kage (OR = = 2��39)�, anal blo�kage (OR = = 2��39)�, anal blo�kage (OR = 2��39)�, anal blo�kage (OR = 2��39)�, anal blo�kage (OR = = = 2��07)� an� ��s�hasia (OR = 1��98)� s���to�s re�aine� = 1��98)� s���to�s re�aine� = 1��98)� s���to�s re�aine� 1��98)� s���to�s re�aine� 1��98)� s���to�s re�aine� signifi�antl� �ifferent fro� health� subje�ts�� O�� ratios re�orte� in a stu�� re�eale� that suffering �iabetes �as asso�iate� �ith suffering a �ental �isor�er [23] �� Gastrointestinal s���to�s negati�el� affe�t health relate� qualit� of life in �iabetes an� �lini�ians shoul� �onsi�er �s��ho-logi�al fa�tors in the treat�ent of GI s���to�s��…”

The Effect of Emotional Stress and Depression on the Prevalence of Digestive Diseases

“…[6][7][8][9] This association is probably derived from mutual and reciprocal interactions between the brain and the gut. 8,13 Corticotropin-releasing hormone (CRH), a major mediator of the stress response in the brain-gut axis, can increase intestinal permeability and lead to FD and IBS. In addition, serotonin and the serotonin transporters, which assist the modulation of feelings and behavior such as anxiety and depression, can be associated with brain-gut function in functional GI disorders.…”

The Irritable Bowel Syndrome: How Stress Can Affect the Amygdala Activity and the Brain-Gut Axis

“…IBS and fibromyalgia are classified by some authors as central sensitization syndromes (Woolf 2011). A majority of IBS patients associate stressful life events with initiation or exacerbation of their symptoms (Whitehead, et al 1992) and stress is able to act at all levels of the physiopathology of IBS (see below). Globally, a concept has emerged that IBS is the result of a dysfunction of the brain-gut interplay, as conceptualized in the brain-gut axis.…”