Parental, Perinatal, and Childhood Risk Factors for Development of Irritable Bowel Syndrome: A Systematic Review

J Neurogastroenterol Motil. 2020 Oct 30;26(4):437-446. doi: 10.5056/jnm20109.

En X S Low 1, Maimouna N K Al Mandhari 2, Charles C Herndon 3, Evelyn X L Loo 4 5, Elizabeth H Tham 5 6, Kewin T H Siah 2 7


Author information

  • 1Department of Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.
  • 2Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.
  • 3G Oppenheimer Center for Neurobiology of Stress and Resilience (CNSR), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
  • 4Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
  • 5Departments of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
  • 6Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore, Singapore.
  • 7Departments of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.


Background/aims: Adverse early life experiences are associated with the development of stroke, cancer, diabetes, and chronic respiratory and ischemic heart diseases. These negative experiences may also play a role in the development of irritable bowel syndrome (IBS)--a functional gastrointestinal disease. This review discusses the research to date on the parental, perinatal, and childhood risk and protective factors associated with the development of IBS.

Methods: A literature search was completed for studies published between 1966 and 2018 that investigated premorbid factors occurring during the perinatal and childhood periods as well as parental factors that were associated with the development of IBS.

Results: Twenty-seven studies fulfilled the review criteria. Risk factors that appeared in more than one study included: (1) parental IBS, substance abuse, parental punishment, and rejection as parental risk factors; (2) low birth weight as a perinatal risk factor; and (3) crowded living conditions in low-income families, childhood anxiety, depression, or child abuse as childhood risk factors. Protective factors for IBS were emotional warmth from the parents and being born to an older mother.

Conclusions: More effort is needed to identify what fetal and maternal factors are associated with low birth weight and IBS. A well-executed prospective birth cohort with a collection of bio-samples and functional data will provide a better understanding of how adversity and the interplay between genetics, epigenetics, and numerous risk factors affect the development of IBS.

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