Abstract

The role of resilience in irritable bowel syndrome, other chronic gastrointestinal conditions and the general population

Clin Gastroenterol Hepatol. 2020 Aug 21;S1542-3565(20)31152-6.doi: 10.1016/j.cgh.2020.08.043. Online ahead of print.

Colleen H Parker 1, Bruce D Naliboff 2, Wendy Shih 2, Angela P Presson 3, Lisa Kilpatrick 2, Arpana Gupta 2, Cathy Liu 2, Laurie A Keefer 4, Jenny S Sauk 5, Robert Hirten 4, Bruce E Sands 4, Lin Chang 6

 
     

Author information

  • 1G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California;; Division of Gastroenterology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • 2G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • 3Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City Utah.
  • 4Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
  • 5UCLA Center for Inflammatory Bowel Diseases, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • 6G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Disease, David Geffen School of Medicine at UCLA, Los Angeles, California;. Electronic address: linchang@mednet.ucla.edu.

Abstract

Background: Resilience is the ability to adapt positively to stress and adversity. It is a potential therapeutic target as it is reduced in irritable bowel syndrome (IBS) compared to healthy controls and associated with worse symptom severity and poorer quality of life. The aim of this study was to examine if these findings are generalizable by comparing resilience between IBS versus the general population and other chronic gastrointestinal (GI) conditions.

Methods: Participants in the general population completed an online survey containing questionnaires measuring demographics, diagnosis of IBS and other GI conditions, symptom severity, psychological symptoms, resilience, and early adverse life events (EALs). IBS was defined as having a physician diagnosis of IBS and/or meeting Rome criteria without co-morbid GI disease. All others were included in the general population group. The chronic GI conditions group included those with inflammatory bowel disease, celiac disease and/or microscopic colitis.

Results: Resilience was lower in IBS (n=820) than the general population (n=1026; p<0.001) and associated with worse IBS symptom severity (p<0.05). Global mental health affected resilience differently in IBS compared to the general population (all p's<0.05). EALs were associated with decreased ability to bounce back from adversity in both IBS and the general population(p<0.001). Resilience scores were similar in IBS and other chronic GI conditions that present with similar symptoms.

Conclusion: Resilience is lower compared to the general U.S. population but does not appear to be specific to IBS as it is comparable to other chronic GI conditions. Low resilience negatively affects symptom severity and mental health and thus, may serve as a novel therapeutic target.

© Copyright 2013-2020 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.