Cited by 432Gastrointestinal motility and disordersPsychosomatic Disorders and Their TreatmentsInfant Health and Development

Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction.

Open access
Whitehead, W E, Crowell, M D, Robinson, J C, Heller, B R, Schuster, M M·1992·Gut

Abstract

A standardised inventory of stressful life events and a bowel symptom questionnaire were administered at three month intervals for one year to 383 women who were unselected with respect to bowel symptoms. A NEO Personality Inventory was given initially to assess neuroticism. Subjects who satisfied restrictive diagnostic criteria for irritable bowel syndrome were compared with those who complained of abdominal pain plus altered bowel habits but who did not meet restrictive diagnostic criteria (functional bowel disorder) and with controls without bowel dysfunction. The irritable bowel group showed significantly higher levels of stress than the other two groups even when the confounding effects of neuroticism were statistically controlled for. Time lagged correlations showed that stress in one three month interval was significantly correlated with bowel symptoms in the subsequent three month interval for all groups. The slope of the regression line relating stress to bowel symptoms was significantly steeper for the irritable bowel group than for the other two groups at three and six months, suggesting that subjects with irritable bowel syndrome show a greater reactivity to stress. Stress scores were also significantly correlated with the number of disability days and the number of medical clinic visits for bowel symptoms.

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  • Recent investigations have found that mindfulness meditation induces changes in neural circuits implicated in interoception and emotion regulation, while improving attentional control.

    “Recent investigations have found that mindfulness meditation induces changes in the activation of neural circuits implicated in interoception (awareness of stimuli originating inside the body (21)) and emotion regulation (22,23), while improving attentional control (24–27).”

    From Mindfulness training reduces the severity of irritable bowel syndrome in women: Results of a randomized controlled trial (2011) · cites this paper as [26]

    Citation (21) is attached specifically to the definition of interoception as awareness of stimuli originating inside the body, not to the sentence’s other claims about meditation. The Abstract and Discussion examine stressful life events and bowel symptoms; searches for interoception and awareness of internal bodily stimuli found no passage defining the term. (LLM, conf=0.76)

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  • Early life experiences, adult stressors, lack of social support, and other social learning experiences can affect physiological and psychological responses and may precipitate abdominal distress and psychiatric disorders.

    “Early life experiences (e.g., abuse), adult stressors (e.g., divorce or bereavement), lack of social support, and other social learning experiences can affect both an individual’s physiological and psychological responses, and may precipitate abdominal distress, as well as psychiatric disorders (4,7–11).”
  • Different types of psychological stressors, including early-life stress and sustained stress, have been recognized as risk factors or promoters of events that result in disease exacerbation in patients with ulcerative colitis and IBS.

    “Although different types of psychological stressors, including early-life stress and sustained stress, have been recognized as risk factors or promoters of events that result in disease exacerbation in patients with ulcerative colitis2 and IBS,3”

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Authors
Whitehead, W. E., Crowell, M. D., Robinson, J. C., Heller, B. R., & Schuster, M. M.
Affiliations
Johns Hopkins University (US)
Venue
Gut
Publisher
BMJ
Published
1992-06
Volume
33
Issue
6
Pages
825-830
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
OpenAlex
W2091075637
Cited by
432
References
21
Citations by year
2026: 1 · 2025: 3 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 9 · 2020: 16 · 2019: 13 · 2018: 14 · 2017: 7 · 2016: 16 · 2015: 18 · 2014: 12 · 2013: 14 · 2012: 17
FWCI
6.72
Type
journal article
Language
en
Open access
Locations
  • Gut (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (2k05mh000133-17, 5r01nr001369-03)
  • National Institute of Mental Health (KO5 MH00133)
  • National Institute of Nursing Research (R01 NR01369)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Health Professions › Pharmacy › Infant Health and Development
Keywords
irritable bowel syndrome, life events, bowel symptoms, functional bowel disorders, stress reactivity, neuroticism, abdominal pain, altered bowel habits, disability days, women
MeSH terms
Adult, Colonic Diseases, Functional, Constipation, Diarrhea, Female, Humans, Life Change Events, Neurotic Disorders, Personality Inventory, Prospective Studies, Stress, Psychological

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