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      Risk and Protective Factors Related to Early Adverse Life Events in Irritable Bowel Syndrome :

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          Abstract

          Irritable bowel syndrome (IBS) is a stress-sensitive disorder of brain-gut interactions associated with a higher prevalence of early adverse life events (EALs). However, it is incompletely understood how trauma severity or disclosure influence the risk of developing IBS or symptom severity. To determine whether: 1) IBS patients report a greater number of EALs compared with healthy controls (HCs), 2) trauma severity and first age of EAL increase the odds of IBS, 3) confiding in others reduces the odds of IBS, 4) the number, trauma severity, and first age of EAL are associated with symptom severity, 5) sex differences exist. In total, 197 IBS patients (72% women, mean age=30.28 years) and 165 HCs (59% women, mean age=30.77 years) completed the Childhood Traumatic Events Scale (CTES), measuring severity of EALs and degree of confiding in others. Regression analyses were used to predict IBS status from EALs and association between gastrointestinal (GI) symptoms and EALs. A greater number of EALs [odds ratio (OR)=1.36, 95% confidence interval (CI), 1.14–1.62; p<0.001) and higher perceived trauma severity (OR=1.13, 95% CI, 1.08–1.19; p<0.001) were associated with increased odds of IBS. Confiding in others decreased the odds of having IBS (OR=0.83, 95% CI, 0.72–0.96; p=0.012). The first age of EAL was not predictive of IBS. No sex differences were found. Assessing the traumatic severity of EALs and amount of confiding in others is important as they can affect the risk of having IBS. Our findings emphasize early intervention to improve health outcomes in individuals with EALs.

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          Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism.

          Intestinal permeability and psychological stress have been implicated in the pathophysiology of IBD and IBS. Studies in animals suggest that stress increases permeability via corticotropin-releasing hormone (CRH)-mediated mast cell activation. Our aim was to investigate the effect of stress on intestinal permeability in humans and its underlying mechanisms.
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            Childhood Adversity and Adult Chronic Disease

            Adverse childhood experiences (ACEs), including child abuse and family dysfunction, are linked to leading causes of adult morbidity and mortality. Most prior ACE studies were based on a nonrepresentative patient sample from one Southern California HMO.
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              The Visceral Sensitivity Index: development and validation of a gastrointestinal symptom-specific anxiety scale.

              Anxiety related to gastrointestinal sensations, symptoms or the contexts in which these may occur is thought to play a significant role in the pathophysiology as well as in the health outcomes of patients with irritable bowel syndrome. To develop a valid and reliable psychometric instrument that measures gastrointestinal symptom-specific anxiety. External and internal expert panels as well as a patient focus group evaluated a large pool of potential item stems gathered from the psychological and gastrointestinal literature. Potential scale items were then administered to 96 patients diagnosed with irritable bowel syndrome along with a set of validating questionnaires. Final item selection was based upon rigorous empirical criteria and the psychometric properties of the final scale were examined. A final unidimensional 15-item scale, the Visceral Sensitivity Index, demonstrated excellent reliability as well as good content, convergent, divergent and predictive validity. The findings suggest that the Visceral Sensitivity Index is a reliable, valid measure of gastrointestinal symptom-specific anxiety that may be useful for clinical assessment, treatment outcome studies, and mechanistic studies of the role of symptom-related anxiety in patients with irritable bowel syndrome.
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                Author and article information

                Journal
                Journal of Clinical Gastroenterology
                Journal of Clinical Gastroenterology
                Ovid Technologies (Wolters Kluwer Health)
                0192-0790
                2020
                January 2020
                : 54
                : 1
                : 63-69
                Article
                10.1097/MCG.0000000000001153
                6802286
                30575634
                081dd731-5268-4355-9353-339b9789612a
                © 2020
                History

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