Patients with IBS have higher prevalence of early adverse life events

American Gastroenterological AssociationMar 30 2012

Patients with irritable bowel syndrome (IBS) have a significantly greater prevalence of early adverse life events , including general trauma as well as physical, emotional and sexual abuse, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association.

"Various types of early adverse events are associated with the development of irritable bowel syndrome, particularly among women," said Lin Chang, MD, of the David Geffen School of Medicine at the University of California Los Angeles and lead author of this study. "Addressing early adverse events and associated psychological symptoms in these patients is important and may help guide management approaches that reduce symptoms and improve overall well-being."

Although associations between an abuse history and IBS have been reported before, in the current study, researchers aimed to assess simultaneously the association of a range of traumatic events - not limited to abuse - with IBS and the impact of differences in gender and psychological factors on these associations. Men and women with IBS who were 18 years of age and older were recruited primarily from community advertisements in the greater Los Angeles area. Early adverse life events were evaluated in 294 IBS patients (79 percent were women) and 435 controls (77 percent were women). Validated questionnaires assessed gastrointestinal, psychological and somatic symptoms.

Compared with controls, IBS patients reported a higher prevalence of general trauma, physical punishment, emotional abuse and sexual events. These events included witnessing violence, mental illness in the family, emotional abuse, and being forced to touch intimate parts of a person's body or have genital sex. These significant differences were observed mainly in women. Emotional abuse was the strongest predictor of IBS. Further, the strength of the relationship between the early trauma and IBS was reduced after controlling for the presence of psychological and other non-gastrointestinal symptoms.

Early adverse life events refer to traumatic experiences during childhood encompassing physical, sexual or emotional abuse, as well as discordant relationships with a primary caretaker, or the loss of a parent. These events appear to be associated with an increased vulnerability toward developing functional gastrointestinal disorders, including IBS.