The psychological and emotional traumas experienced over a lifetime--such as the death of a loved one, divorce, natural disaster, house fire or car accident, physical or mental abuse -- may contribute to adult irritable bowel syndrome (IBS), according to the results of a study unveiled at the American College of Gastroenterology's (ACG) 76th Annual Scientific meeting in Washington, DC.
In, "A Case-Control Study of Childhood and Adult Trauma in the Development of Irritable Bowel Syndrome (IBS)," researchers from the Mayo Clinic in Rochester, MN, found that childhood and adult traumas are more common among adults with IBS, but to a lesser degree among affected and unaffected case relatives. In addition, general life traumas were more commonly reported than physical, emotional or sexual abuse. Of the 2623 study participants, patients reported more traumas over a lifetime than controls with traumas common before age 18 as well as after age 18.
"While stress has been linked to IBS, and childhood abuse has been reported to be present in up to 50 percent of patients with IBS, at a prevalence twice that of patients without IBS, most studies of abuse have focused on sexual abuse with sparse detail and also have not looked at other forms of psychological trauma," said Yuri Saito-Loftus, MD, who presented the findings. "This is the first study that looks at multiple forms of trauma, the timing of those traumas, and traumas in a family setting."
IBS is a chronic functional gastrointestinal disorder which for many sufferers is marked by abdominal discomfort, bloating, constipation and/or diarrhea and can be categorized based on these symptoms: IBS-D is accompanied by diarrhea, IBS-C is accompanied by constipation and IBS-M includes both diarrhea and constipation.
Research suggests that IBS is caused by changes in the nerves and muscles that control sensation and motility of the bowel. IBS is 1.5 times more common in women than in men and is most commonly diagnosed in people under the age of 50.
Trauma may sensitize the brain and the gut, according to Dr. Saito-Loftus, who said that the results of this study indicate that patients with IBS experience or report traumas at a level higher than patients without IBS.
In the United States, it is estimated that 10-15 percent of the adult population suffers from IBS symptoms, yet only 5 to 7 percent of adults have been diagnosed with the disease. IBS is the most common disease diagnosed by gastroenterologists and one of the most common disorders seen by primary care physicians. According to studies, IBS patients make more visits to their physicians, undergo more diagnostic tests, are prescribed more medications, miss more workdays, have lower work productivity, are hospitalized more frequently, and account for greater overall direct healthcare costs than patients without IBS. The burden of illness for IBS is significant: research suggests that IBS can have such a severe impact on Health-Related Quality of Life that it has been linked to an increase in suicidal behavior.
"Patients and their families frequently wonder, 'why me?', 'why did this [IBS] happen?,'" said Dr. Saito Loftus. She said it's important for patients' and their healthcare providers' to understand the potential link between prior stressful experiences and IBS. "This will help them understand why IBS happened to them, why stress continues to play a role in their IBS symptoms."
She also urged patients and their healthcare providers not to "underplay" the role of stress in their symptoms. "Someone who thinks they have coped with their traumatic experiences adequately on their own and continues to have IBS symptoms should be encouraged to explore professional evaluation and treatment for traumatic life experiences. "
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