Abstract

Negative Events During Adulthood are Associated With Symptom Severity and Altered Stress Response in Patients With Irritable Bowel Syndrome

Parker CH1, Naliboff BD1, Shih W2, Presson AP3, Videlock EJ1, Mayer EA1, Chang L4. Clin Gastroenterol Hepatol. 2019 Jan 4. pii: S1542-3565(19)30002-3. doi: 10.1016/j.cgh.2018.12.029. [Epub ahead of print]
 
     

Author information

1 G Oppenheimer Center for the Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles.

2 G Oppenheimer Center for the Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles; Center of Health Research, School of Public Health, Loma Linda University, Loma Linda, California.

3 Department of Biostatistics, David Geffen School of Medicine, University of California, Los Angeles; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.

4 G Oppenheimer Center for the Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles. Electronic address: linchang@mednet.ucla.edu.

Abstract

BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is a stress-sensitive disorder associated with dysregulation of the hypothalamic-pituitary-adrenal pathway. We studied the cumulative effect of events during adulthood on this pathway in patients with IBS.

METHODS: We studied 129 patients with IBS, based on Rome III criteria (mean age 28.1 years, 66% women), and 108 healthy individuals (controls; mean age 29.8 years, 60% women) who completed the Life Experiences Survey from August 2013 to September 2017. Data were collected on the presence and effects of events since age 18, IBS severity scores, and IBS-related quality of life. For a subset of subjects, we measured serum cortisol and adrenocorticotropic hormone (ACTH) production in response to administration of corticotrophin-releasing factor and ACTH.

RESULTS: Compared with controls, patients with IBS perceived more adulthood life events as negative and had a significantly higher negative life event impact score (14.17±12.04 vs 10.83±9.98; P=.022). In patients with IBS, the presence of more-negatively perceived adulthood life events was associated with worse IBS symptom severity (β=1.53, 95% CI, 0.21-2.84; P=.025) and IBS-related quality of life (β=-0.70; 95% CI, -1.02 to -0.38; P<.001). Negatively perceived adulthood life events were associated with reduced production of ACTH in response to corticotrophin-releasing factor in patients with IBS compared with controls (P<.05).

CONCLUSION: In a study of more than 200 subjects, we associated more-negatively perceived events during adulthood with an increased risk for IBS, worse symptom severity and quality of life, and a dysregulated stress response. Understanding the effects of events that cause stress in adults and their perceived effects on IBS may help guide disease management.

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