Abstract
Despite stress being considered a key factor in the pathophysiology of the functional gastrointestinal (GI) disorder irritable bowel syndrome (IBS), there is a paucity of information regarding the ability of IBS patients to respond to acute experimental stress. Insights into the stress response in IBS could open the way to novel therapeutic interventions. To this end, we assessed the response of a range of physiological and psychological parameters to the Trier Social Stress Test (TSST) in IBS. Thirteen female patients with IBS and 15 healthy female age-matched control participants underwent a single exposure to the TSST. Salivary cortisol, salivary C-reactive protein (CRP), skin conductance level (SCL), GI symptoms, mood and self-reported stress were measured pre- and post-exposure to the TSST. The hypothalamic-pituitary-adrenal (HPA) axis response to the TSST was sustained in IBS, as shown by a greater total cortisol output throughout (p = 0.035) and higher cortisol levels measured by an area under the curve with respect to ground (AUCG) analysis (p = 0.044). In IBS patients, GI symptoms increased significantly during the recovery period following exposure to the TSST (p = 0.045). Salivary CRP and SCL activity showed significant changes in relation to stress but with no differential effect between experimental groups. Patients with IBS exhibit sustained HPA axis activity, and an increase in problematic GI symptoms in response to acute experimental psychosocial stress. These data pave the way for future interventional studies aimed at identifying novel therapeutic approaches to modulate the HPA axis and GI symptom response to acute psychosocial stress in IBS.
Highlights
Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal (GI) tract, most commonly associated with symptoms of abdominal pain or discomfort, bloating and a significant change in bowel habits, with no clearly identifiable GI pathology (Longstreth et al 2006)
Observational studies have identified that stressors, such as early life trauma (Chitkara et al 2008) or chronic stressful life events experienced in adolescence or adulthood (Blanchard et al 2008), are major risk factors for IBS
IBS patients were in the moderate symptom severity range as measured by the IBS Symptom Severity Scale (IBS-SSS) (175–300), and healthy controls exhibited no problematic GI symptoms (IBS v. control, p < 0.001)
Summary
Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal (GI) tract, most commonly associated with symptoms of abdominal pain or discomfort, bloating and a significant change in bowel habits, with no clearly identifiable GI pathology (Longstreth et al 2006). The underlying pathophysiology of IBS is still poorly understood It is widely viewed as a disorder caused by a dysregulation of the complex interactions that exist along the brain–gut axis (Grenham et al 2011). Observational studies have identified that stressors, such as early life trauma (Chitkara et al 2008) or chronic stressful life events experienced in adolescence or adulthood (Blanchard et al 2008), are major risk factors for IBS. These clinical observations have been substantiated by numerous pre-clinical rodent studies that have shown that. We assessed the response of a range of physiological and psychological parameters to the Trier Social Stress Test (TSST) in IBS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
