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

被引:26
作者
Parker, Colleen H. [1 ]
Naliboff, Bruce D. [1 ]
Shih, Wendy [1 ,2 ]
Presson, Angela P. [3 ,4 ]
Videlock, Elizabeth J. [1 ]
Mayer, Emeran A. [1 ]
Chang, Lin [1 ]
机构
[1] Univ Calif Los Angeles, David Geffen Sch Med, G Oppenheimer Ctr Neurobiol Stress & Resilience, Vatche & Tamar Manoukian Div Digest Dis,Dept Med, Los Angeles, CA 90095 USA
[2] Loma Linda Univ, Sch Publ Hlth, Ctr Hlth Res, Loma Linda, CA 92350 USA
[3] Univ Calif Los Angeles, David Geffen Sch Med, Dept Biostat, Los Angeles, CA 90095 USA
[4] Univ Utah, Dept Internal Med, Div Epidemiol, Salt Lake City, UT 84112 USA
基金
美国国家卫生研究院;
关键词
Life Events Survey; LES; Hypothalamic-Pituitary-Adrenal; HPA; Quality of Life; Irritable Bowel Syndrome; IBS; FUNCTIONAL GASTROINTESTINAL DISORDERS; ADVERSE CHILDHOOD EXPERIENCES; LIFE EVENTS; AXIS DYSREGULATION; IMPACT;
D O I
10.1016/j.cgh.2018.12.029
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is a stress-sensitive disorder associated with dysregulation of the hypothalamic-pituitary-adrenal axis. 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 corticotropin-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 (beta = 1.53, 95% CI, 0.21-2.84; P = .025) and IBS-related quality of life (beta = -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 corticotropin-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.
引用
收藏
页码:2245 / 2252
页数:8
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