Gastroenterology

Gastroenterology

Volume 140, Issue 3, March 2011, Pages 761-765.e5
Gastroenterology

Mini-Reviews and Perspectives
The Role of Stress on Physiologic Responses and Clinical Symptoms in Irritable Bowel Syndrome

https://doi.org/10.1053/j.gastro.2011.01.032Get rights and content

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The Association of Early Adverse Life Events and IBS

Early adverse life events (EALs) refer to traumatic experiences during childhood including, but not limited to, maladjusted relationships with a parent or primary caregiver, severe illness or death of a parent, and physical, sexual, or emotional abuse. Converging neurobiology and epidemiology studies suggest that EALs, such as abuse and other traumatic events, cause sustained brain dysfunction resulting in alterations in stress-responsive neurobiological systems, which in turn, increase the

ANS Tone

The sympathetic and parasympathetic branches of the ANS mediate brain–gut communication largely through modulation of the third ANS branch, the enteric nervous system, and alterations in ANS output and interactions may play a role in IBS.46, 47 Through its 3 divisions, the ANS modulates and coordinates GI motility, secretion, and immune function.48, 49

In addition to the alterations in gut motility and transit that have been reported in IBS,50 studies measuring cardioautonomic tone in IBS

Summary and Future Directions

There is strong evidence to support that IBS is a stress-sensitive disorder. In a predisposed individual, sustained stress can result in enhanced responsiveness of central stress circuits, dysregulation of adaptive systems, and an increased vulnerability to develop functional disorders, including IBS. EALs have been shown to be associated with multiple medical illnesses and negative health behaviors. Animal models and, more recently, human studies support the impact of early life stress on the

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Conflicts of interest The author discloses no conflicts.

Funding Dr Chang is supported by NIH grants P50 DK64539 and AR46122.

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