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

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

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

DOI 10.1136/gut.33.6.825PMC PMC1379344

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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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The social readjustment rating scale
Holmes, T. H., & Rahe, R. H. (1967) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(67)90010-4 · Cited by 11,502
Assessing the impact of life changes: Development of the Life Experiences Survey.
Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.46.5.932 · Cited by 2,788
Towards positive diagnosis of the irritable bowel.
Manning, A. P., Thompson, W., Heaton, K. W., & Morris, A. F. (1978) · BMJ · doi:10.1136/bmj.2.6138.653 · Cited by 1,404
Psychosocial Factors in the Irritable Bowel Syndrome
Drossman, D. A., McKee, D. C., Sandler, R. S., Mitchell, C. M., Cramer, E. M., Lowman, B. C., & Burger, A. L. (1988) · Gastroenterology · doi:10.1016/s0016-5085(88)80017-9 · Cited by 757
Scaling of Life Events
Paykel, E. S. (1971) · Archives of General Psychiatry · doi:10.1001/archpsyc.1971.01750160052010 · Cited by 736
Bowel Patterns Among Subjects Not Seeking g Health Care
Drossman, D. A., Sandler, R. S., McKee, D. C., & Lovitz, A. J. (1982) · Gastroenterology · doi:10.1016/s0016-5085(82)80186-8 · Cited by 711
Tolerance for Rectosigmoid Distention in Irritable Bowel Syndrome
Whitehead, W. E., Holtkötter, B., Enck, P., Hoelzl, R., Holmes, K. D., Anthony, J. C., Shabsin, H. S., & Schuster, M. M. (1990) · Gastroenterology · doi:10.1016/0016-5085(90)90332-u · Cited by 592
Self-citation
THE IRRITABLE COLON SYNDROME
Chaudhary, N. A., & Truelove, S. C. (1962) · QJM · doi:10.1093/oxfordjournals.qjmed.a066971 · Cited by 498
Symptoms of Psychologic Distress Associated With Irritable Bowel Syndrome
Whitehead, W. E., Bosmajian, L., Zonderman, A. B., Costa Jr., P. T., & Schuster, M. M. (1988) · Gastroenterology · doi:10.1016/s0016-5085(88)80018-0 · Cited by 480
Self-citation
Social Psychologic Factors Affecting the Presentation of Bodily Complaints
Mechanic, D. (1972) · New England Journal of Medicine · doi:10.1056/nejm197205252862105 · Cited by 468

Show all 21 references

Research works printed but not linked: 1

Whitehead WE. Gastrointestinal motility disorders - the psychologist's perspective. In: Champion MC, McCallum RW, eds. Physiology, diagnosis & therapv in GI motilitv disorders. Toronto: MES Medical Education Services, 1988: 109-22.

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Weinland, S. R., Morris, C. B., Dalton, C. B., Hu, Y., Whitehead, W. E., Toner, B. B., Diamant, N. E., Leserman, J., Bangdiwala, S. I., & Drossman, D. A. (2010) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.748 · Cited by 32
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Bener, A. (2012) · World Journal of Diabetes · doi:10.4239/wjd.v3.i6.123 · Cited by 29
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Orr, W. C. (2001) · Sleep Medicine Reviews · doi:10.1053/smrv.2000.0149 · Cited by 30
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“Furthermore, IBS patients tend to be more vulnerable to stressful events in daily life [13].”
Background
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Sach, J., Bolus, R. R., FitzGerald, L., Naliboff, B. D., Chang, L., & Mayer, E. A. (2002) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2002.07110.x · Cited by 29
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Wu, H., Liu, H., Zhang, Z.-A., Zhou, E.-H., Wang, X., Jiang, B., Shi, Z., Zhou, C.-L., Li, Q., & Ma, X. (2009) · Neuroscience Letters · doi:10.1016/j.neulet.2009.09.018 · Cited by 28
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Choi, Y., Youn, Y. H., Kang, S. J., Shin, J. E., Cho, Y. S., Jung, Y. S., Shin, S. Y., Huh, C. W., Lee, Y. J., Koo, H. S., et al. (2025) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm25007 · Cited by 36
“…the effectiveness of lubiprostone, we analyzed data from RCTs, specifically those conducted by Johanson et al 220 and Chang et al. 222 These studies examined the daily doses of 16, 32, and 64 μ g of lubiprostone and compared their effects on abdominal pain and bloating improvement against placebo.”
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“found a higher level of stress in patients with IBS compared to controls and these IBS patients also demonstrated a greater reactivity to stress [19].”
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“However, meal stimulation may not directly affect the brain regions which mediate pathophysiological conditions of IBS.”
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Background
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Fukudo, S. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-382026-6.00028-2 · Cited by 13
Seirogan (Wood Creosote) Inhibits Stress-Induced Ion Secretion in Rat Intestinal Epithelium
Ataka, K., Kuge, T., Venkova, K. M., & Meerveld, B. G. (2003) · Digestive Diseases and Sciences · doi:10.1023/a:1024155125366 · Cited by 13
“Digestive Diseases and Sciences, Vol. 48, No. 7 (July 2003) 1307 P1: FYJ pp692-ddas-469534 DDAS.cls June 11, 2003 10:28 ATAKA ET AL Psychosocial and physical stressful stimuli are known to cause gastrointestinal dysfunction and have been shown to provoke the clinical manifestation of IBS symptoms, including diarrhea (…”
BackgroundInfluential
Sex differences in the perception of stressful life events in a Spanish sample: Some implications for the Axis IV of the DSM-IV
Caballo, V. E., & Cardeña, E. (1997) · Personality and Individual Differences · doi:10.1016/s0191-8869(97)00036-6 · Cited by 13
How lifestyle changes within the COVID-19 global pandemic have affected the pattern and symptoms of the menstrual cyclePreprint
Bruinvels, G., Goldsmith, E., Blagrove, R. C., Martin, D., Shaw, L., & Piasecki, J. (2021) · medRxiv · doi:10.1101/2021.02.01.21250919 · Cited by 13
“Despite the differences between elite and non-elite athletes, 346 there was a clear overall change in bloating for all participants, which aligns with increasing 347 reports of the effects of stress and anxiety on the gut (Wilson, 2020; Whitehead et al., 1992; 348 Simpson and Stakes, 1987).”
Result
Current perspectives on irritable bowel syndrome: a narrative review
Hojo, M., & Nagahara, A. (2022) · Journal of International Medical Research · doi:10.1177/03000605221126370 · Cited by 13
“Psychological stress and gut microbiota play important roles in the pathophysiology of IBS.(28,29) Mental stress may further affect not only intestinal bacteria but also intestinal mucosal permeability.”
Background
Involvement of toll-like receptor 5 on mouse model of colonic hypersensitivity induced by neonatal maternal separation
Mallaret, G., Lashermes, A., Méleine, M., Boudieu, L., Barbier, J., Aissouni, Y., Gelot, A., Chassaing, B., Gewirtz, A. T., Ardid, D., et al. (2022) · World Journal of Gastroenterology · doi:10.3748/wjg.v28.i29.3903 · Cited by 13
Analysis of autonomic function during natural defecation in patients with irritable bowel syndrome using real-time recording with a wearable device
Nakata, R., Tanaka, F., Sugawara, N., Kojima, Y., Takeuchi, T., Shiba, M., Higuchi, K., & Fujiwara, Y. (2022) · PLoS ONE · doi:10.1371/journal.pone.0278922 · Cited by 12
“Compared to healthy subjects, patients with IBS show exacerbated symptoms [33] and an increased stress response [34] due to added stress; therefore, it is important to reduce discomfort during measurement to accurately evaluate the ANS.”
Background
The Irritable Bowel Syndrome: How Stress Can Affect the Amygdala Activity and the Brain-Gut Axis
Bonaz, B. L., Sonia Pellissier, A., Sinniger, V., Clarençon, D., Peinnequin, A., & Canini, F. (2012) · InTech eBooks · doi:10.5772/52066 · Cited by 12
Levodopa acts centrally to induce an antinociceptive action against colonic distension through activation of D2 dopamine receptors and the orexinergic system in the brain in conscious rats
Okumura, T., Nozu, T., Kumei, S., Takakusaki, K., Miyagishi, S., & Ohhira, M. (2016) · Journal of Pharmacological Sciences · doi:10.1016/j.jphs.2016.01.007 · Cited by 12
Primary healthcare utilisation and self-rated health among patients with Irritable Bowel Syndrome: What are the impacts of comorbidities, gastrointestinal symptom burden, sense of coherence and stress?
Norlin, A., Faresjö, Å., Falk, M., Jones, M. P., & Walter, S. (2019) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2019.01.015 · Cited by 12
Functional changes induced by psychological stress are not enough to cause intestinal inflammation in Sprague–Dawley rats
Jorge, E., Fernández, J. A., Torres, R., Vergara, P., & Martín, M. T. (2010) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2010.01507.x · Cited by 12
Constructive thinking, rational intelligence and irritable bowel syndrome
Rey, E., Moreno-Ortega, M., Alonso, M. O. G., & Díaz‐Rubio, M. (2009) · World Journal of Gastroenterology · doi:10.3748/wjg.15.3106 · Cited by 14
Efficacy and mode of action of mesalazine in the treatment of diarrhoea-predominant irritable bowel syndrome (IBS-D): study protocol for a randomised controlled trial
Leighton, M., Lam, C., Mehta, S. P., & Spiller, R. E. (2013) · Trials · doi:10.1186/1745-6215-14-10 · Cited by 14
“Patients often believe that stress aggravates their symptoms but there is a poor correlation between stress and symptoms on a day-to-day basis [2].”
Background
Maternal separation and TNBS-induced gut inflammation synergistically alter the sexually differentiated stress response in rats
Hasegawa, R., Saito‐Nakaya, K., Gu, L., Kanazawa, M., & Fukudo, S. (2023) · BioPsychoSocial Medicine · doi:10.1186/s13030-022-00258-x · Cited by 11
Gastrointestinal disorders
Mayer, E. A., & Brunnhuber, S. (2012) · Handbook of clinical neurology · doi:10.1016/b978-0-444-52002-9.00036-x · Cited by 11
A prospective 1‐year follow‐up study in patients with functional or organic dyspepsia: changes in gastrointestinal symptoms, mental distress and fear of serious illness
Pajala, M., Heikkinen, M., & Hintikka, J. J. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.03108.x · Cited by 11
De la colopathie fonctionnelle à la neurogastroentérologie
Ducrotte, P. R. (2009) · Gastroentérologie Clinique et Biologique · doi:10.1016/j.gcb.2009.07.006 · Cited by 11
Effects of Body Awareness Therapy in Patients with Irritable Bowel Syndrome
Eriksson, E., Nordwall, V., Kurlberg, G., Rydholm, H., & Eriksson, A. (2002) · Advances in Physiotherapy · doi:10.1080/140381902320387540 · Cited by 11
“They are also more vulnerable to stress (7).”
Background
Irritable bowel syndrome
Sach, J., & Chang, L. (2002) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-002-0049-3 · Cited by 11
Irritable bowel syndrome : Managing the Patient with Abdominal Pain and Altered Bowel Habits
Lynn, R. B., & Friedman, L. S. (1995) · Medical Clinics of North America · doi:10.1016/s0025-7125(16)30074-8 · Cited by 11
Non-pharmacological treatments in the irritable bowel syndrome
Leahy, A. (2001) · World Journal of Gastroenterology · doi:10.3748/wjg.v7.i3.313 · Cited by 11
Comprehensive psychological intervention to improve outcome in functional gastrointestinal disorder: a cohort study
Wang, Y.-T., Kwok, K., Sm, T., Yek, M. H., Ong, W., Barbier, S., & Ng, B. (2015) · Singapore Medical Journal · doi:10.11622/smedj.2015109 · Cited by 10
The Effect of Korean Hand Acupuncture on Young, Single Korean Students With Irritable Bowel Syndrome
Park, H., & Cha, C. (2012) · Gastroenterology Nursing · doi:10.1097/sga.0b013e318274b1f2 · Cited by 10
Free fecal water in the horse – an unsolved problem
Ertelt, A., & Gehlen, H. (2015) · Pferdeheilkunde Equine Medicine · doi:10.21836/pem20150308 · Cited by 10
Functional Dyspepsia
Lee, S. I. (2005) · Journal of the Korean Medical Association · doi:10.5124/jkma.2005.48.1.48 · Cited by 10
Carbohydrate Elimination or Adaptation Diet for Symptoms of Intestinal Discomfort in IBD: Rationales for “Gibsons’ Conundrum”
Fung, Q. M., & Szilagyi, A. (2012) · International Journal of Inflammation · doi:10.1155/2012/493717 · Cited by 9
Impact of mindfulness tendency and physical activity on brain-gut interactions
Koseki, T., Muratsubaki, T., Tsushima, H., Morinaga, Y., Oohashi, T., Imafuku, M., Suzuki, Y., Kanazawa, M., & Fukudo, S. (2023) · Journal of Gastroenterology · doi:10.1007/s00535-022-01938-9 · Cited by 9
“IBS patients express steeper correlation coefficient between psychosocial stress and gastrointestinal symptoms than healthy controls [13].”
Background
Symptom classification in irritable bowel syndrome as a guide to treatment
Wiesner, M., Naylor, S. J., Copping, A., Furlong, A., Lynch, A. G., Parkes, M., & Hunter, J. O. (2009) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520902964705 · Cited by 9
Psychophysiologie des Eingeweideschmerzes
Musial, F. (2002) · Der Schmerz · doi:10.1007/s00482-002-0189-3 · Cited by 9
Subtypes of Anal Incontinence Associated With Bowel Dysfunction: Clinical, Physiologic, and Psychosocial Characterization
Crowell, M. D., Lacy, B. E., Schettler, V. A., Dineen, T. N., Olden, K. W., & Talley, N. J. (2004) · Diseases of the Colon & Rectum · doi:10.1007/s10350-004-0646-4 · Cited by 9
“The Hopkins Bowel Symptom Questionnaire (HBSQ) was completed at intake by all patients.(14,15) The HBSQ consists of series of questions regarding abdominal pain and bowel symptoms; both upper and lower gastrointestinal symptoms are queried.”
MethodSelf-citation
Measuring the impact of gastrointestinal inconvenience and symptoms on perceived health in the general population – validation of the Short Health Scale for gastrointestinal symptoms (SHS-GI)
Walter, S., Jones, M. P., Sjödahl, J., Stjernman, H., Hjortswang, H., & Andréasson, A. (2021) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.2021.1974087 · Cited by 8
Immune-microbiome interplay and its implications in neurodegenerative disorders
Uniyal, A., Tiwari, V., Rani, M., & Tiwari, V. (2021) · Metabolic Brain Disease · doi:10.1007/s11011-021-00807-3 · Cited by 9
“Moreover, a recent study had stated that stress can affect the composition of gut microbiota which might persist for a long duration that further results in behavioral manipulations (Whitehead et al. 1992).”
Background
Development of colonic transit time and ultrasound imaging tools as objective indicators for assessing abnormal defecation associated with food intake: a narrative review based on previous scientific knowledge
Okawa, Y. (2021) · BioPsychoSocial Medicine · doi:10.1186/s13030-021-00222-1 · Cited by 8
“Previous studies have reported that gastrointestinal symptoms associated with IBS are exacerbated by stress and that there is a correlation between stress load and worsening gastrointestinal symptoms [39].”
Background
Association between Serum Vitamin D and Irritable Bowel Syndrome Symptoms in a Sample of Adults
Abboud, M., Haidar, S. A., Mahboub, N., Papandreou, D., Anouti, F. A., & Rizk, R. (2022) · Nutrients · doi:10.3390/nu14194157 · Cited by 9
“This is in contrast to an abundance of studies that have reported higher gastrointestinal disturbances associated with psychological distress [49,50].”
Result

Authors: Whitehead, W. E., Crowell, M. D., Robinson, J. C., Heller, B. R., & Schuster, M. M.
Affiliations: Johns Hopkins University (US)
ORCID: Whitehead, W E
Crowell, M D
Heller, B R
Venue: Gut
Publisher: BMJ
Published: 1992-06
Volume: 33
Issue: 6
Pages: 825-830
ISSN: 0017-5749 (ISSN-L)
1468-3288
DOI: 10.1136/gut.33.6.825
PMC: PMC1379344
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: bronze
doi.org
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 › Medicine › Pediatrics, Perinatology and Child Health › 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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Effects of stressful life events on bowel symptoms: subjects with irritable bowel syndrome compared with subjects without bowel dysfunction.

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