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Level of chronic life stress predicts clinical outcome in irritable bowel syndrome
Open accessAbstract
Background—Life stress contributes to symptom onset and exacerbation in the majority of patients with irritable bowel syndrome (IBS) and functional dyspepsia (FD); research evidence is conflicting, however, as to the strength of these effects. Aims—To test prospectively the relation of chronic life stress threat to subsequent symptom intensity over time. Patients—One hundred and seventeen consecutive outpatients satisfying the modified Rome criteria for IBS (66% with one or more concurrent FD syndromes) participated. Methods—The life stress and symptom intensity measures were determined from interview data collected independently at entry, and at six and 16 months; these measures assessed the potency of chronic life stress threat during the prior six months or more, and the severity and frequency of IBS and FD symptoms during the following two weeks. Results—Chronic life stress threat was a powerful predictor of subsequent symptom intensity, explaining 97% of the variance on this measure over 16 months. No patient exposed to even one chronic highly threatening stressor improved clinically (by 50%) over the 16 months; all patients who improved did so in the absence of such a stressor. Conclusion—The level of chronic life stress threat predicts the clinical outcome in most patients with IBS/FD.
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“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).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [11]
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“a critical event in the onset of clinical symptoms of GI disorders including irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) [7], [8], [9], [10]”
From CRF induces intestinal epithelial barrier injury via the release of mast cell proteases and TNF-α (2012) · cites this paper as [8]
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Metadata
- Authors
- Bennett, E. J., Tennant, C. C., Piesse, C., Badcock, C.-A., & Kellow, J. E.
- Affiliations
- Royal North Shore Hospital (AU)
- Corresponding author
- Kellow, J E
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1998-08-01
- Volume
- 43
- Issue
- 2
- Pages
- 256-261
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1727204
- OpenAlex
- W2101601471
- Cited by
- 405
- References
- 35
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 11 · 2020: 10 · 2019: 14 · 2018: 9 · 2017: 10 · 2016: 11 · 2015: 7 · 2014: 23 · 2013: 20 · 2012: 21
- FWCI
- 13.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- 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, functional dyspepsia, symptom intensity, clinical outcomes, symptom exacerbation
- MeSH terms
- Adult, Chronic Disease, Colonic Diseases, Functional, Emotions, Female, Humans, Male, Personality, Prognosis, Prospective Studies, Stress, Psychological, Time Factors, Age Distribution, Sex Distribution
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