Clinical—Alimentary TractChildhood Trauma Is Associated With Hypothalamic-Pituitary-Adrenal Axis Responsiveness in Irritable Bowel Syndrome
Section snippets
Study Subjects and Recruitment
IBS patients age 18–55 years were recruited from specialty clinics and community advertisements, fulfilled ROME II29 diagnostic criteria, and diagnosis was confirmed by a gastroenterologist with expertise in IBS (L.C.). Healthy controls were recruited by newspaper or Internet advertisement from the community, did not have a history of IBS, other chronic pain conditions, or psychiatric illness, and were not taking centrally acting drugs (anxiolytics, narcotics, or antidepressants). None of the
Subject Characteristics
The characteristics of the subjects are summarized in Table 1. The IBS patients included 26 women and 19 men, and the control group included 22 healthy women and 19 healthy men. The IBS patients had higher HAD anxiety and depression scores than controls. There were 3 subjects without data on EAL, and there were 7 additional subjects who were eliminated from AUC analysis because of incomplete cortisol data (women: 1 control without EAL, 2 IBS [1 without EAL, 1 with sexual abuse]; men: 2 controls
Discussion
In the present study, we have shown that in response to a visceral stressor: (1) IBS patients and controls with EALs have a greater cortisol response compared with individuals without EALs; (2) this difference was more pronounced among men than women; (3) IBS patients and controls have similar salivary cortisol responses; (4) among IBS patients with EALs, there was a trend to have higher cortisol levels immediately after the stressor; and (5) in IBS, a slower return of stimulated cortisol to
References (63)
Postinfectious irritable bowel syndrome
Gastroenterology
(2003)- et al.
Hypothalamic-pituitary-gut axis dysregulation in irritable bowel syndrome: plasma cytokines as a potential biomarker?
Gastroenterology
(2006) - et al.
High and low unstimulated salivary cortisol levels correspond to different symptoms of functional gastrointestinal disorders
J Psychosom Res
(2005) - et al.
Dysfunction of the hypothalamic-pituitary-adrenal axis and functional somatic symptoms: a longitudinal cohort study in the general population
Psychoneuroendocrinology
(2009) - et al.
Gastrointestinal tract symptoms and self-reported abuse: a population-based study
Gastroenterology
(1994) - et al.
The role of childhood trauma in the neurobiology of mood and anxiety disorders: preclinical and clinical studies
Biol Psychiatry
(2001) - et al.
The impact of adverse childhood experiences on health problems: evidence from four birth cohorts dating back to 1900
Prev Med
(2003) Understanding the potency of stressful early life experiences on brain and body function
Metabolism
(2008)The impact of early adverse care on HPA axis development: nonhuman primate models
Horm Behav
(2006)- et al.
Effects of early and recent adverse experiences on adrenal response to psychosocial stress in depressed adolescents
Biol Psychiatry
(2008)
Repetitive sigmoid stimulation induces rectal hyperalgesia in patients with irritable bowel syndrome
Gastroenterology
Saliva and serum cortisol dynamics following intravenous dexamethasone in normal volunteers
Life Sci
Saliva cortisol levels following dexamethasone administration in endogenously depressed patients
Life Sci
Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change
Psychoneuroendocrinology
Why do we respond so differently?Reviewing determinants of human salivary cortisol responses to challenge
Psychoneuroendocrinology
Childhood parental loss and adult hypothalamic-pituitary-adrenal function
Biol Psychiatry
Early life stress alters behavior, immunity, and microbiota in rats: implications for irritable bowel syndrome and psychiatric illnesses
Biol Psychiatry
Diminished cortisol responses to psychosocial stress associated with lifetime adverse eventsA study among healthy young subjects
Psychoneuroendocrinology
Decreased adrenocorticotropic hormone and cortisol responses to stress in healthy adults reporting significant childhood maltreatment
Biol Psychiatry
Hyperresponsiveness of hypothalamic-pituitary-adrenal axis to combined dexamethasone/corticotropin-releasing hormone challenge in female borderline personality disorder subjects with a history of sustained childhood abuse
Biol Psychiatry
Epigenetic mechanisms of perinatal programming of hypothalamic-pituitary-adrenal function and health
Trends Mol Med
The relationship between somatisation and outcome in patients with severe irritable bowel syndrome
J Psychosom Res
Assessment of the hypothalamic-pituitary-adrenal axis over a 24-hour diurnal period and in response to neuroendocrine challenges in women with and without childhood sexual abuse and posttraumatic stress disorder
Biol Psychiatry
Gastric suction at birth associated with long-term risk for functional intestinal disorders in later life
J Pediatr
Evolving pathophysiologic models of functional gastrointestinal disorders
Gastroenterology
Childhood trauma and diurnal cortisol disruption in fibromyalgia syndrome
Psychoneuroendocrinology
Functional bowel disorders
Gastroenterology
V. Stress and irritable bowel syndrome
Am J Physiol Gastrointest Liver Physiol
The role of psychological and biological factors in postinfective gut dysfunction
Gut
Altered visceral perceptual and neuroendocrine response in patients with irritable bowel syndrome during mental stress
Gut
Maladaptive intestinal epithelial responses to life stress may predispose healthy women to gut mucosal inflammation
Gastroenterology
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by National Institutes of Health grants P50 DK64539 (E.A.M., L.C.), R01 AR46122 (L.C.), R24 AT002681 (E.A.M.), and GCRC M01-RR00865.