Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct;28(10):1508-17.
doi: 10.1111/nmo.12848. Epub 2016 May 5.

The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS)

N Kanuri  1 , B Cassell  1 , S E Bruce  2 , K S White  2 , B M Gott  3 , C P Gyawali  1 , G S Sayuk  4   5   6
Affiliations

The impact of abuse and mood on bowel symptoms and health-related quality of life in irritable bowel syndrome (IBS)

N Kanuri et al. Neurogastroenterol Motil. 2016 Oct.

Abstract

Background: Irritable bowel syndrome (IBS) is a common abdominal pain disorder without an organic explanation. Abuse histories (physical, sexual, emotional) are prevalent in IBS. While abuse relates to mood disorders (depression and anxiety) also common in IBS, the influence of abuse on gastrointestinal (GI) symptoms and health-related quality of life (HRQOL) and its independence from psychological symptom comorbidity has not been studied.

Methods: Consecutive GI outpatients completed the ROME III Research Diagnostic Questionnaire and questionnaires on trauma (Life-Stress Questionnaire), mood (Beck Depression/Anxiety Inventories), somatic symptoms (PHQ-12), and HRQOL (SF-36). Current GI symptom severity and bother were assessed using 10-cm Visual Analog Scales.

Key results: 272 ROME-defined IBS (47.6 ± 0.9 years, 81% female) and 246 non-FGID (51.6 ± 1.0 years, 65% female) subjects participated. IBS patients reported greater rates of physical, sexual, and emotional abuse (p < 0.006 each), and higher depression, anxiety, and somatic symptoms (p < 0.001). Greater bowel symptom bother (7.4 ± 0.2 vs 6.7 ± 0.2, p = 0.040), severity (7.7 ± 0.2 vs 6.5 ± 0.2, p < 0.001), recent symptomatic days (9.8 ± 0.4 vs 8.5 ± 0.3, p = 0.02), and poorer HRQOL (40.9 ± 2.3 vs 55.5 ± 1.7, p < 0.001) were noted in IBS with abuse. Abuse effects were additive, with greater IBS symptom severity and poorer HRQOL noted in cases with multiple forms of abuse. Mediation analyses suggested that abuse effects on GI symptoms and HRQOL were partially mediated by mood.

Conclusions & inferences: Abuse experiences common among IBS sufferers are associated with reports of greater GI symptoms and poorer HRQOL, particularly in those with multiple forms of abuse; this relationship may be partially mediated by concomitant mood disturbances.

Keywords: abuse; depression; health-related quality of life; irritable bowel syndrome.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Percentage of abuse in sample with and without IBS
Figure 2
Figure 2
IBS severity compared with scaled health-related quality of life score across increasing number of forms of abuse.
Figure 3
Figure 3
Group statistics comparing means of the sample with IBS and abuse to IBS and no abuse. *Denotes comparisons that are significant at p ≤ 0.05; **at p ≤ 0.001.
See this image and copyright information in PMC

References

    1. Salmon P, Skaife K, Rhodes J. Abuse, dissociation, and somatization in irritable bowel syndrome: towards an explanatory model. Journal of behavioral medicine. 2003 Feb;26(1):1–18. PubMed PMID: 12690943. - PubMed
    1. Chitkara DK, van Tilburg MA, Blois-Martin N, Whitehead WE. Early life risk factors that contribute to irritable bowel syndrome in adults: a systematic review. The American journal of gastroenterology. 2008 Mar;103(3):765–74. quiz 75. PubMed PMID: 18177446. Pubmed Central PMCID: 3856200. - PMC - PubMed
    1. Cheung CW, Qiu Q, Choi SW, Moore B, Goucke R, Irwin M. Chronic opioid therapy for chronic non-cancer pain: a review and comparison of treatment guidelines. Pain physician. 2014 Sep-Oct;17(5):401–14. PubMed PMID: 25247898. - PubMed
    1. Leserman J, Li Z, Drossman DA, Hu YJ. Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits. Psychological medicine. 1998 Mar;28(2):417–25. PubMed PMID: 9572098. Epub 1998/05/08. eng. - PubMed
    1. Drossman DA, Li Z, Leserman J, Toomey TC, Hu YJ. Health status by gastrointestinal diagnosis and abuse history. Gastroenterology. 1996 Apr;110(4):999–1007. PubMed PMID: 8613034. - PubMed