Trauma history and risk of the irritable bowel syndrome in women veterans

Abstract

Background: Over 1.8 million women in the U.S. are veterans of the armed services. They are at increased risk of occupational traumas, including military sexual trauma.

Aim: To evaluate the association between major traumas and irritable bowel syndrome among women veterans accessing Veteran Affairs (VA) healthcare.

Methods: We administered questionnaires to assess trauma history as well as IBS, post-traumatic stress disorder (PTSD) and depression symptoms to 337 women veterans seen for primary care at VA Women's Clinic between 2006 and 2007. Logistic regression was used to evaluate the association between individual traumas and IBS risk after adjustment for age, ethnicity, PTSD and depression.

Results: Irritable bowel syndrome prevalence was 33.5%. The most frequently reported trauma was sexual assault (38.9%). Seventeen of eighteen traumas were associated with increased IBS risk after adjusting for age, ethnicity, PTSD and depression, with six statistically significant [range of adjusted odds ratios (OR) between 1.85 (95% CI, 1.08-3.16) and 2.6 (95% CI, 1.28-3.67)]. Depression and PTSD were significantly more common in IBS cases than controls, but neither substantially explained the association between trauma and increased IBS risk.

Conclusions: Women veterans report high frequency of physical and sexual traumas. A lifetime history of a broad range of traumas is independently associated with an elevated risk of the irritable bowel syndrome.

Fig 1

History of Sexually Abusive Traumas reported on Trauma Questionnaire (TQ) by final 83 women veteran study participants^*. ^*Only 1 missing value (1%) ^{^}Sexual abuse in childhood by age 13 and perpetrated by someone at least 5 years older. ^{^^}TQ-defined sexual assault or sex against will by force or threat of force occuring at least once during military service. ^{^^^}Any non-childhood sexual assault that occurred at any time other than during military service. ^{^^^^}Given TQ question structure, can only determine if MSA or another non-MSA occured but not if both an MSA and a non-MSA occurred.