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Is there a relationship between early childhood trauma and Irritable Bowel Syndrome?
Over the past 20 years, a number of articles have reported that people who suffer traumatic experience in childhood, including emotional, physical and sexual abuse, suffer negative health effects in adulthood.
Patients with GI illness –like IBS-- are statistically more likely to have such a history compared to a control population. However, this association is not only seen in functional illness since there is also an incidence of prior abuse in Crohn’s disease.
Recently, an article was published that examined which type of childhood trauma was most common in patients with IBS. Compared with controls, IBS patients reported a significantly higher rate of emotional abuse, physical punishment, and sexual abuse. But emotional abuse was the strongest predictor! Fifty-eight percent of IBS patients and only 25% of controls had experienced emotional abuse. In addition, 35 % of patients stated that their parents or care-takers often failed to understand them or their needs compared to 14% of controls. The authors also reported higher rates of psychological problems in abused patients, which may be one of the pathways from abuse to IBS.
These differences were seen mostly in women. This may be related, in part, to fewer men in the study and to findings in a previous study that men have a greater cortisone response to rectal pain than women, which may be protective.
This study raises some interesting questions. How does abuse result in IBS symptoms? Why are women more affected? What can be done to help patients with a history of trauma?
At the MBDC, we believe that at the very least, those patients whose IBS symptoms do not respond to medical treatment, may benefit from referral to a psychologist. Psychologists can help individuals make sense of the early experience, narrating and witnessing it, so that the experience is no longer trapped in the body. Treating someone with a history of abuse is beyond the training and expertise of gastroenterologists and this is one example of the importance of physicians and psychologists working together to help IBS patients.
posted on January 21, 2013