Irritable Bowel Syndrome Women Research Articles

Role of Sex, Anxiety, and Resilience in the Association between Adverse Childhood Experiences and Irritable Bowel Syndrome

Adverse childhood experiences (ACE) are associated with increased risk of irritable bowel syndrome (IBS), a female-predominant chronic abdominal disorder. Factors contributing to this association have not been well-studied. We compared sex differences in ACE for adults with and without IBS and evaluated the impact of anxiety and resilience on the relationship between ACE and IBS. Sex and disease differences in total score and ACE subtypes from the ACE Questionnaire in subjects with IBS and control subjects were assessed. Cross-sectional mediation analysis determined if anxiety (Hospital Anxiety and Depression Scale) and resilience (Connor-Davidson Resilience Scale or Brief Resilience Scale) mediated the relationship between ACE and IBS. Of 798 participants studied, 368 met IBS diagnostic criteria (265 women, 103 men) and 430 were healthy control subjects (277 women, 153 men). Prevalence and number of ACE were higher in IBS versus control subjects (P < .001) but similar between IBS women and men. Household mental illness increased odds of having IBS in women (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.35-2.85; false discovery rate [FDR], 0.002) and men (OR, 2.32; 95% CI, 1.26-4.33; FDR, 0.014). Emotional abuse increased odds of having IBS in women (OR, 1.94; 95% CI, 1.23-3.09; FDR, 0.019) and sexual abuse increased odds of IBS in men (OR, 3.54; 95% CI, 1.35-10.38; FDR, 0.027). Anxiety mediated 54% (P < .001) of ACE's effect on IBS risk and resilience mediated 12%-14% (Connor-Davidson Resilience Scale, P= .008; Brief Resilience Scale, P= .018). Both men and women with a history of ACE are twice as likely to have IBS than those without an ACE. Anxiety mediated the relationship between ACE and IBS in men and women and resilience mediated this relationship only in women.

Serum Calcium alteration Correlates With Worsening of Lipid Profile and oxidant/ antioxidant status in women with Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is known to be a heterogeneous disease, characterized by abdominal pain and disorders of intestinal motility. This study aims at investigating if serum calcium levels correlate with lipid values in IBS and the oxidant / antioxidant system as one of the factors proposed in the etiology of IBS. A total of 70 patient’s women with IBS were included in this study. 70 healthy subjects were selected to form the control group. Total cholesterol, triglycerides, calcium, Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-), superoxide (O2), carbonyls proteins (Pc) and malondialdehyde (MDA) and nitric oxide (NO) concentrations were studied in all patients and controls. The characteristics of the study population show that the mean age is 45 ± 3 and 47 ± 4 years for control women and IBS women respectively, as well as women with IBS is overweight Calcium significantly decreased while increasing total cholesterol and triglycerides in women IBS . MDA, carbonyls proteins, NO and O2 concentrations were significantly higher in IBS patients than in controls. The vitamin C, Catalase, SOD and GSH activities patients with IBS were significantly lower than that of controls. These results suggest that alterations in lipid profile, level of calcium and the oxidant/ antioxidant system may play a role in the pathogenesis of IBS.

The Efficiency of Emotion Regulation and Distress Tolerance Based on Dialectical Behavior Therapy on Anxiety Sensitivity and Emotion Regulation Difficulties in Women with Irritable Bowel

Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder that affects social, occupational, communicational, and psychological functioning. Therefore, the aim of this research was to determine the effect of emotional regulation and distress tolerance skills based on Dialectical Behavior Therapy (DBT) on anxiety sensitivity and emotion regulation difficulties among women with IBS. Methods: In order to conduct this study, a sample of 30 women with IBS who referred to Tehran healthcare centers was selected using the convenience sampling. Then, participants were assigned to experimental and control groups randomly. In this pretest-posttest semi-experimental study, we used anxiety sensitivity index questionnaire and the emotion regulation questionnaire. The experimental group received the educational intervention in 10 sessions during two and a half months. Data were analyzed by SPSS software. Results: The results showed that DBT had a significant effect on anxiety sensitivity and emotional regulation difficulties in women with IBS (P-value &lt; 0.001). So, this treatment could reduce the anxiety sensitivity and emotional regulation difficulties in with IBS women. Conclusion: According to the results, DBT educations can reduce the anxiety sensitivity and negative emotion regulation and increase the positive emotion regulation.

High risk of lower urinary tract symptoms in patients with irritable bowel syndrome.

The aim of the present study was to investigate the prevalence of urinary tract infection (UTI) and the risk of lower urinary tract symptoms (LUTS) in women with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhea, and mixed) compared to women in the general population. Between January 2014 and December 2015, consecutive adult female patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy women with regular bowel habits were enrolled in the study. At baseline, we checked for UTI with a dipstick test and questioned patients about the presence of LUTS in the previous 24h. We enrolled 141 IBS patients and 91 healthy controls in the study. There was no difference in the prevalence of UTI between IBS patients and healthy controls (4.9 vs 3.3%, p=0.5). When we excluded patients with UTI, we found a 2.79 higher risk of increased urinary frequency [odds ratio (OR) 2.79, 95% confidence interval (CI) 1.37-5.68], a 2.68 higher risk of urinary urgency (OR 2.68, 95% CI 1.04-6.91), and more than three times the risk of having dysuria (OR 3.25, 95% CI 1.06-9.97) in IBS women compared to healthy controls. The risk of having at least one urinary symptom was independent of IBS subtype and IBS severity. Our study shows that IBS women have a similar risk of UTI compared to healthy women even if they complain more of LUTS, independently of IBS subtype and severity.

Comprehensive Self-Management Reduces the Negative Impact of Irritable Bowel Syndrome Symptoms on Sexual Functioning

Women with irritable bowel syndrome (IBS) report sexual dysfunction. Comprehensive self-management (CSM) intervention has been shown to reduce gastrointestinal, psychological, and somatic symptoms in IBS women. Whether this intervention also reduces sexual dysfunction is not known. We sought to compare demographic and clinical factors in IBS women with and without sexual dysfunction as defined by the Arizona sexual experiences scale (ASEX) and to test the effects of CSM treatment on sexual dysfunction scores and on the sexual relations subscale of an IBS quality of life (IBSQOL) scale which measures the effect of IBS on sexual QOL. IBS (Rome II) women enrolled in a randomized clinical trial of CSM treatment were characterized as having sexual dysfunction (N = 89) or not (N = 86) at baseline based on ASEX criteria. Baseline characteristics and symptoms were compared between the two groups. Post-intervention changes were compared between the CSM and the usual care arms of the randomized trial. Women meeting ASEX criteria for sexual dysfunction were older, had higher lifetime depression and antidepressant use, more primary care/MD visits, fewer mental healthcare visits, and greater sleep disturbance than those without sexual dysfunction. No significant group differences in gastrointestinal or somatic symptoms were observed. Compared with usual care treatment, CSM increased sexual QOL scores and had a weaker effect on ASEX scores. Severity of IBS symptoms at baseline did not differ between IBS women with or without sexual dysfunction. The CSM intervention can reduce the effect of IBS on sexual QOL.

Catecholamine and cortisol levels during sleep in women with irritable bowel syndrome

Evidence suggests that patients with irritable bowel syndrome (IBS) are hyper-responsive to environmental, physical and visceral stimuli. IBS patients also frequently report poor sleep quality. This study compared serum cortisol and plasma catecholamine levels during sleep between women with IBS (n = 30) and healthy controls (n = 31), and among subgroups within the IBS sample based on predominant stool patterns, IBS-diarrhoea (n = 14), IBS-constipation (n = 7) and IBS-alternators (n = 9). Cortisol was measured from serial blood samples drawn every 20 min, and catecholamines every hour, in a sleep laboratory from 8 pm until awakening. Because of the varied sleep schedules of the individual participants, each subject's hormone series time base was referenced with respect to their onset of Stage 2 sleep. Overall, there were no significant differences in cortisol or catecholamine patterns between women with IBS and controls, nor were there any group by time interactions. However, women with constipation-predominant IBS demonstrated significantly increased noradrenaline, adrenaline and cortisol levels throughout the sleep interval, and women with diarrhoea-predominant IBS were significantly lower on noradrenaline and cortisol. These results suggest that differences in neuroendocrine levels during sleep among IBS predominant bowel pattern subgroups may be greater than differences between IBS women and controls. Neuroendocrine profiles during sleep may contribute to our understanding of symptom expression in IBS.

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) results in a poor quality of life and absenteeism due to unpredictable abdominal pain, diarrhea, and bloating. IBS has prevalence rates of approximately 6% to 22% in various countries, and more women than men are diagnosed with this disorder. This study explored how Taiwanese women with IBS gain knowledge about the disorder and studied their experiences in using alternative remedies. An ethnographic study design involving interviews and Internet online discussions was used. Women (18-45 years) either diagnosed with IBS or with self-reported symptoms that met the Rome II criteria were included. All interviews were transcribed verbatim and analyzed by the constant comparison method. Results showed that symptom pattern recognition was used most often by participants to interpret symptoms. The bodily practices of the IBS women followed Taiwanese gender norms, with bodily experiences being represented as a dialogue between the disordered body and the social body. Linking diarrhea with social norms of female slenderness, IBS women applied cultural strategies to manage symptoms. The findings facilitate a partnership between healthcare professionals and IBS women, which can facilitate the development of an appropriate self-management manual, self-help groups, and Internet discussion groups to facilitate symptom management. It is hoped that this study will enhance nurse understanding of the traditional Chinese view of the body and the corresponding dietary practices used to harmonize the body's yin and yang. Although Asian women may resist Western medications due to their side effects, study results provide nurses with information on alternative therapies that may be more acceptable in the Asian context. In conclusion, the bodily experiences and practices of women with IBS are developed from personal cultural views of the body and gender norms.

Help−seeking process in women with irritable bowel syndrome. Part 1: study results

This study explores the entire help−seeking process in women with irritable bowel syndrome (IBS). A mixed−method design was chosen for this study. The qualitative part (grounded theory) supports the help-seeking process′s theorization and the quantitative part describes two possible predictors (abdominal pain and psychological distress). Nineteen IBS women (confirmed by Rome II criteria) were included in the study. Interviews and testing (pain and distress) were done. The emerging model includes three categories: health problem; personal characteristics; and help-seeking process. These categories allow an understanding of the help−seeking process and the role of distress. Part 2 of this article will be discussing the results of this study.

A Population-Based Case–Control Study of Work and Psychosocial Problems in Patients With Irritable Bowel Syndrome—Women Are More Seriously Affected Than Men

Everyday psychosocial functioning and quality of life are known to be reduced for patients with irritable bowel syndrome (IBS), but few previous studies have analyzed associations with functioning in working life. Accordingly, we examined perceptions of working conditions, functioning in the workplace, quality of life, and psychological complaints among IBS patients compared with age- and sex-matched controls. A case-control study design was used based on 347 IBS patients from Swedish general practice who were compared with age- and sex-matched controls (N = 1,041) randomly selected from the general population. A survey was performed including validated questions concerning job strain, quality of life (SF-36 [Short Form 36]), absence because of illness, depression, anxiety, and sleeping habits. The IBS patients reported considerably more often that their daily performance in working life was affected by their gastrointestinal problems (OR [odds ratio] 7.14, 95% CI 5.45-9.36). Male IBS cases only reported less authority regarding decisions on their working pace (OR 5.44, 95% CI 1.28-23.18), while female IBS patients reported less decision authority regarding planning their work (OR 2.29, 95% CI 1.13-4.64), fewer learning opportunities at work (OR 2.12, 95% CI 1.26-3.57), and more long-term sick leave than their controls (OR 3.70, 95% CI 1.94-7.07). The female IBS cases also reported lower quality of life in all dimensions than their controls. In particular, female IBS patients reported lower authority over decisions at work and problems in their daily functioning in the workplace. These associations persisted after adjustments for possible confounders such as mood, sleeping problems, and perceived health.

(715): Is clinical pain consistent with experimental one in IBS women complaining of abdominal pain?

Women with Irritable Bowel Syndrome (IBS) seek help when their abdominal pain (AP) becomes unbearable. Many researchers identified that process, but few of them specifically measured pain. Aiming to theorize help seeking processes, we used a mixed methodological design (quantitative and qualitative) to study pain perception of 19 women (18-65 years). Our sample was divided into two groups: Women (n=11) who had consulted a physician and women (n=8) that didn’t (NC). Clinical pain was assessed with the use of a daily pain diary and pain recall.

Perception of Electrocutaneous Stimuli in Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) and fibromyalgia syndrome (FMS) are common conditions with some similarities, but different perceptual responses to somatic and visceral stimuli. The purpose of this study was to assess in a large group of IBS patients the somatic perception by transcutaneous electrical nerve stimulation (TENS) and its relation to the level of severity and presence of FMS. In 99 patients grouped by the validated functional bowel disorder severity index (FBDSI) in mild, moderate, and severe IBS and in 33 healthy controls (HC), we studied discomfort thresholds and perception of somatic stimuli at control (hands and elbows) and active (trapezius) sites by TENS and by using a specific questionnaire. The use of TENS showed that IBS showed significant higher thresholds and lower perception cumulative score compared to HC. The severity of IBS is significantly associated with age and mean control site values for discomfort and borderline associated with gender in the ordinal model constructed for the ascending series protocol. The severity of IBS is also significantly associated with the active cumulative perception score in the long stimulus protocol. Due to limited sample size of IBS men with FMS, analyses of discomfort thresholds and cumulative perception score by FMS were done only for women. IBS women without FMS had significantly higher mean control site values for discomfort and significantly lower active cumulative perception score than HC. IBS women with FMS had significantly lower mean active site values for discomfort thresholds than IBS women without FMS (Dunn's test p < 0.05). IBS patients showed somatic hypoalgesia to electrical stimuli. The severity of IBS and the presence of FMS influence the perception of somatic stimuli induced by TENS.

Abdominal Pain Impacts Quality of Life in Women with Irritable Bowel Syndrome

Patients with irritable bowel syndrome (IBS) report lower health-related quality of life (QoL) as compared to healthy controls. The aims of this analysis were to describe which IBS symptoms were rated on a daily diary as most distressing/severe by IBS women, and determine which IBS symptoms were most predictive of lower QoL and have the greatest impact on daily life. This report is a secondary analysis of prospective and retrospective symptom severity and impact data, collected on 242 women with IBS, aged 18-48, who were studied between 1997 and 2004. On the daily diary, intestinal gas was the most frequent IBS symptom with subjects reporting at least minimal intestinal gas on 74% of days and moderate or worse severity on 27% of days. Abdominal pain occurred at least minimally on 62% of days. Diarrhea was the least common. Across women, abdominal pain was most strongly related to life impact variables and QoL, followed by intestinal gas and bloating. Analysis of day-to-day variation within women showed that abdominal pain was most strongly correlated with daily life impact variables and constipation had the weakest correlation. While diarrhea had a lower correlation with life impact, this was due to the low prevalence of diarrhea. When it occurs, diarrhea has a large impact. Partial correlation analysis showed that the impact of diarrhea is independent of abdominal pain. Abdominal pain is the most disruptive IBS symptom. Diarrhea also has an independent and significant impact when it occurs, especially in those with diarrhea-predominant IBS.

Upper Gastrointestinal and Mental Symptoms in the Irritable Bowel Syndrome

Gastrointestinal and mental symptoms were assessed in 101 outpatients with the irritable bowel syndrome (IBS). A normal female population was used for comparison of mental symptoms. By definition all patients had abdominal pains and/or change of bowel habits (constipation or diarrhoea, or both) but no demonstrable organic disease. Upper gastrointestinal symptoms without peptic ulcer disease were reported by 87% of the patients. Mental symptoms were reported by almost all patients. Symptoms of anxiety, fatiguability, hostile feelings, sadness, and sleep disturbances were seen significantly more often among IBS women than in the controls. We conclude that patients with IBS frequently have upper gastrointestinal and mental symptoms that should be taken into account in the therapeutic management and evaluation of new modes of treatment.