The Impact of Rotating Shift Work on the Prevalence of Irritable Bowel Syndrome in Nurses

Abstract

OBJECTIVES-Shift work has been associated with gastrointestinal symptoms such as abdominal pain, constipation, and diarrhea. These symptoms overlap with those reported by patients with functional bowel disorders. Because shift work will lead to misalignment between the endogenous circadian timing system and the external 24 h environment, we hypothesized that nurses participating in shift work will have a higher prevalence of functional bowel disorders when compared with nurses participating in day shifts.METHODS-Nurses engaged in patient care were invited to complete Rome III, irritable bowel syndrome-quality of life measure (IBS-QOL) and modified Sleep-50 questionnaires. Respondents were classified as working day, night, or rotating shifts. The prevalence of IBS, functional constipation, functional diarrhea, and individual gastrointestinal symptoms was determined.RESULTS-Data were available for 399 nurses (214 day shift, 110 night shift, and 75 rotating shift workers). Rotating shift nurses had a significantly higher prevalence of IBS compared to day shift nurses (48% vs. 31%, P < 0.01). Multivariable logistic regression correcting for age, gender, and sleep quality proved this association robust. IBS-QOL scores among groups were similar. Prevalence of functional constipation and functional diarrhea was similar between groups. Rotating shift nurses had a significantly higher prevalence of abdominal pain compared to day shift (81% vs. 54%, P < 0.0001) and night shift workers (61%, P = 0.003).CONCLUSIONS-Participation in shift work, especially rotating shift work, is associated with the development of IBS and abdominal pain that is independent of sleep quality. Circadian rhythm disturbances may have a function in the pathogenesis of IBS and abdominal pain.

Update on Irritable Bowel Syndrome Program of Research

“…Such findings are further supported by studies with nurses and medical residents who report more GI symptoms when working shift work or nights (Nojkov, Rubenstein, Chey, & Hoogerwerf, 2010).…”

Association Between Irritable Bowel Syndrome and Shift Work: Prevalence and Associated Factors Among Nurses

“…This is similar to the finding of Nojkov et al [24] among rotating shift nurses. The similarity of this finding may support the role of circadian rhythm in the pathogenesis of IBS in shift workers.…”

“…Association between the ranks of the subjects and the occurrence of IBS showed that 11 (21.2%) each are NOs practice had the highest risk of developing IBS. This is in contrast to the finding of Nojkov et al [24] where no association was found between the number of years of practice and IBS. Possible explanation for this may be because, as the number of years of practice increased the colon could adapt to changes in environmental conditions without compromising its motility.…”

“…However, sleep disturbances alone will not completely explain the association between shift work and IBS. In a study by Nojkov et al [24] after controlling for sleep quality an association was still found between shift work and IBS. It may therefore, imply that the association between rotating shift work and IBS might be as a result of circadian disruption.…”

Shift work and work- related stress symptoms in health care workers in a tertiary hospital in Medellin, Colombia: A cross-sectional study

“…It has been reported that shift work is associated with cancer, diabetes, gastrointestinal disorders, metabolic and cardiovascular disease (Knutsson, 2003;Kubo et al, 2006;Lie, Roessink, & Kjaerheim, 2006;Mosendane, Mosendane, & Raal, 2008;Nojkov, Rubenstein, Chey, & Hoogerwerf, 2010;Pan, Schernhammer, Sun, & Hu, 2011;Wang, Armstrong, Cairns, Key, & Travis, 2011), and the proposed underlying mecha-nisms encompass circadian rhythm disruption, light at night, sleep deprivation, immune depression, lifestyle changes and stress (Boivin & Boudreau, 2014;Brondel, Romer, Nougues, Touyarou, & Davenne, 2010;Bushnell, Colombi, Caruso, & Tak, 2010;Crispim et al, 2011;Fritschi et al, 2011;Hansen, 2001). Specifically, in relation to healthcare work, in which non-regular and night work hours are commonly seen, there is evidence, most of it from studies in nurses, about how this type of job organization can affect workers in a negative way, both physiologically and psychologically (Admi, Tzischinsky, Epstein, Herer, & Lavie, 2008).…”