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A History of Abuse in Community Subjects with Irritable Bowel Syndrome and Functional Dyspepsia: The Role of Other Psychosocial Variables
Natasha A. Koloskid, Nicholas J. Talleya, b, Philip M. Boycec
aMayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn., USA;
bDepartment of Medicine, University of Sydney, Nepean Hospital, Penrith,
cDepartment of Psychological Medicine, University of Sydney, Westmead Hospital, Westmead, and
dSchool of Psychology, University of Queensland, St Lucia Campus, Brisbane, Australia
Digestion 2005;72:86-96 (DOI: 10.1159/000087722)
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Abstract
Background/Aims: Why abuse is associated with irritable bowel syndrome and functional dyspepsia remains unclear but other psychosocial factors may be important. We hypothesized that other psychosocial variables may confound the association. Methods: 207 subjects identified from a previous population survey who also met Rome I criteria for IBS (n = 156) or functional dyspepsia (n = 51) were included in the study. Controls (n = 100) did not report having any abdominal pain in a previous population survey. Sexual, physical, emotional/verbal abuse as a child (13 years) and adult (14 years) was assessed using validated self-report questions. Other psychological variables were assessed via validated self-report. Results: Adulthood abuse was significantly more common in IBS and/or functional dyspepsia (40%) compared with healthy controls (25%). Abuse was not an independent predictor for IBS or functional dyspepsia when psychological and buffering factors were controlled for in the analyses. Having a diagnosis of depression and using a self-controlling coping style were significantly associated with having a history of abuse. Conclusions: Abuse occurring as an adult was significantly associated with IBS and/or functional dyspepsia, but it was not an important factor when psychosocial factors were controlled for in these disorders.
Copyright © 2005 S. Karger AG, Basel
http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ProduktNr=223838&Ausgabe=231318&ArtikelNr=87722
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Psychological factors as a predictor of treatment response in patients with heartburn: A pooled analysis of clinical trials
Authors: Wiklund, Ingela1; Carlsson1, Rolf1; Carlsson, Jonas1; Glise, Hans1
Source: Scandinavian Journal of Gastroenterology, Volume 41, Number 3, Number 3/March 2006, pp. 288-293(6)
Objective . A pooled analysis, using data from three prospective, randomized, double-blind, placebo-controlled, clinical studies, was undertaken to determine the relationship between well-being and subsequent clinical response to acid suppressant therapy in 1887 adult patients with reflux symptoms (with/without endoscopically verified erosive esophagitis).
Material and methods . Well-being was assessed at study entry using the Psychological General Well-Being (PGWB) Index. Patients were assessed for complete relief of heartburn (absence of symptoms in the preceding 7 days) after 4 weeks' treatment (omeprazole 10 or 20?mg once daily; ranitidine 150?mg twice daily).
Results . Multiple logistic regression analysis identified baseline PGWB Index total score and anxiety score as independent prognostic indicators of treatment response in endoscopy-positive patients ( n =1333). Thus, the likelihood of achieving complete heartburn relief was impaired by high baseline levels of anxiety or a low total well-being score. In the endoscopy-negative group, high levels of depression and low vitality scores affected treatment response adversely. Furthermore, age (for endoscopy-positive patients only) and body mass index (for endoscopy-negative patients only) showed an association with treatment outcome. Gender seemed to have no prognostic value on treatment outcome.
Conclusions . Patient well-being may be a useful prognostic indicator in patients presenting with reflux symptoms, with a high level of anxiety predicating against a response to acid suppressant therapy, particularly in those with normal endoscopic findings.
http://www.ingentaconnect.com/content/tandf/sgas/2006/00000041/00000003/art00007
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Gut, Aug 2007; 56: 1066 - 1071.
The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis
Meagan J Spence1 and Rona Moss-Morris2
1 Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
2 School of Psychology, University of Southampton, Highfield, Southampton, UK
Aim: To determine whether a combination of mood and personality factors together with illness beliefs and behaviours predict the onset of irritable bowel syndrome (IBS) post gastroenteritis, as suggested by the cognitive behavioural model of IBS.
Methods: Primary care patients with a positive test for Campylobacter gastroenteritis, and no previous history of IBS or serious bowel conditions were recruited into this prospective study (n = 620). Participants completed a questionnaire at the time of infection, which included standardised measures of mood, perceived stress, perfectionism, negative illness beliefs and illness behaviours. Participants completed follow-up questionnaires designed to determine whether they met the Rome criteria for IBS 3 and 6 months after initial infection.
Results: A total of 49 participants met the criteria for IBS at both follow-up points. Logistic regressions indicated that those who developed IBS had significantly higher levels of perceived stress (1.10, 95% CI 1.02 to–1.15), anxiety (1.14, 95% CI 1.05 to 1.23), somatisation (1.17, 95% CI 1.02 to 1.35) and negative illness beliefs (1.14, 95% CI 1.03 to 1.27) at the time of infection than those who did not develop IBS. Patients with IBS were also significantly more likely to remain active in the face of their acute symptoms until they felt forced to rest (all-or-nothing behaviour) (1.09, 95% CI 1.03 to 1.16), and significantly less likely to initially rest in response to their acute illness (0.93, 95% CI 0.88 to 0.97). Depression and perfectionism were not associated with the onset of IBS.
Conclusions: Results suggest that patients with high stress and anxiety levels are more prone to develop IBS after a bout of gastroenteritis. Additional risk factors include a tendency to interpret illness in a pessimistic fashion and to respond to symptoms in an all-or-nothing manner.
http://gut.bmj.com/cgi/content/abstract/56/8/1066?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=personality&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT
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Personal Relationships, 16 (2009), 147–165.
Printed in the United States of America.
Copyright © 2009 IARR. 1350-4126/09
Interpersonal communication apprehension, topic avoidance, and the experience of irritable bowel syndrome
JENNIFER L. BEVAN
Chapman University
Abstract
Through the lens of the theory of inhibition and confrontation (Pennebaker, 1989), this study explored the
relationships that interpersonal communication apprehension and topic avoidance in one's closest relationship share
with the experience of irritable bowel syndrome (IBS).
Specifically, an online survey that studied U.S. IBS-diagnosed and non-IBS subsamples examined person–partner communication apprehension, amount of overall topic avoidance, and reasons for topic avoidance in relation to four IBS experience variables. Communication apprehension displayed a particularly strong relationship with multiple aspects of the IBS experience, and a number of the communication avoidance variables varied according to IBS diagnosis. Implications for the theoretical understanding of interpersonal communication processes in the specific context of IBS and general chronic health conditions are discussed.
View full PDF article here
(Article posted with author's permission)
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Am J Gastroenterol. 2010 Feb 16.
The Impact of Rotating Shift Work on the Prevalence of Irritable Bowel Syndrome in Nurses.
Nojkov B, Rubenstein JH, Chey WD, Hoogerwerf WA.
Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA.
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.
Am J Gastroenterol advance online publication, 16 February 2010; doi:10.1038/ajg.2010.48.
PMID: 20160712 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20160712
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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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