Irritable bowel syndrome in women: a common health problem

The effect of Korean hand acupuncture on young, single Korean students with irritable bowel syndrome

The purpose of this study was to test the effectiveness of Korean hand acupuncture (KHA) on bowel symptoms, stress, mental health, and heart rate variability in women with irritable bowel syndrome. From a total sample of 42 women with irritable bowel syndrome diagnosed with Rome III, 21 were randomly selected to be given KHA, whereas 21 were given sham KHA. The KHA group received KHA on 16 spots related to bowel symptoms, whereas the sham KHA group received treatment to areas unrelated to bowel symptoms. KHA needles were applied for 25 minutes, twice a week, for 4 weeks. After the treatment, bowel symptoms were measured using a Bowel Symptom Severity Scale, stress using a global assessment of recent health, mental health using the Symptom Checklist-90-Revised, and heart rate variability. SAS 9.1 (SAS Institute, Cary, NC) was used to analyze the data, and a chi-square test, t test, and paired t test were used for analysis. The KHA group had a decrease in symptoms such as loose stool, bloating, abdominal discomfort, and abdominal pain compared with the sham KHA group (p < .05). However, there were no significant effects on stress, mental health, and heart rate variability. KHA was effective for bowel symptoms such as loose stool, bloating, abdominal discomfort, and abdominal pain, and it could be applied to patients with irritable bowel syndrome. There is a need for further research on the effectiveness of KHA in women with irritable bowel syndrome using more diverse physiological indexes.

Frequency of irritable bowel syndrome, entrance examination-related stress, mental health, and quality of life in high school students

The purpose of this study was to examine entrance examination-related stress, mental health, and the quality of life of high school students with and without irritable bowel syndrome. We administered a descriptive survey by collecting data from 1,877 students from eight schools in Gyeonggi province, Korea. This study employed the Rome III criteria for the assessment of irritable bowel syndrome, an entrance examination stress scale for measuring entrance examination-related stress, the revised Symptom Checklist-90-Revised for measuring mental health, and the World Health Organization Quality of Life Scale Abbreviated Version for measuring the quality of life. The frequency of irritable bowel syndrome in students was 19.0%. A majority had a mixed constipation and diarrhea subtype of irritable bowel syndrome. Compared with the high school students without irritable bowel syndrome, those with irritable bowel syndrome reported a significantly higher score on the entrance examination stress scale, Symptom Checklist-90-Revised, and World Health Organization Quality of Life Scale Abbreviated Version. Results suggest support for creating a high school education program that provides knowledge and information about irritable bowel syndrome to students. Furthermore, it is important to explore suitable therapeutic approaches and nursing interventions for this population.

Gender Differences in Cognitive Control: an Extended Investigation of the Stop Signal Task

Men and women show important differences in clinical conditions in which deficits in cognitive control are implicated. We used functional magnetic resonance imaging to examine gender differences in the neural processes of cognitive control during a stop-signal task. We observed greater activation in men, compared to women, in a wide array of cortical and sub-cortical areas, during stop success (SS) as compared to stop error (SE). Conversely, women showed greater regional brain activation during SE > SS, compared to men. Furthermore, compared to women, men engaged the right inferior parietal lobule to a greater extent during post-SE go compared to post-go go trials. Women engaged greater posterior cingulate cortical activation than men during post-SS slowing in go trial reaction time (RT) but did not differ during post-SE slowing in go trial RT. These findings extended our previous results of gender differences in regional brain activation during response inhibition. The results may have clinical implications by, for instance, helping initiate studies to understand why women are more vulnerable to depression while men are more vulnerable to impulse control disorders.

I am doing the best that I can!: Living with inflammatory bowel disease and/or irritable bowel syndrome (part II)

INTRODUCTION

Inflammatory bowel disease (IBD) (Crohn disease or ulcerative colitis) and irritable bowel syndrome (IBS) are 2 gastrointestinal (GI) disorders that are chronic, are debilitating, and diminish quality of life and have no known etiology. Persons with IBD and/or IBS share similar signs and symptoms, although IBS does not result in intestinal inflammation/alteration or increase one's risk for colorectal cancer as does IBD. The literature reports different mechanisms by which to cope with a GI disorder; however, few studies have focused on the life experiences/coping abilities from the perspective of those who have a GI disorder. As such, exploring the lived experiences of women diagnosed with IBD and/or IBS would provide information about coping strategies from the perspective of those affected, which in turn would be useful for other individuals affected by these conditions and individuals treating patients with GI disorders.

PURPOSE

The overall objective of this research was to explore the lived experiences of women diagnosed with the GI disorders of IBD and/or IBS. This article will focus on the strategies that women used for coping with such a diagnosis.

METHODOLOGY

Eight women diagnosed with IBD and/or IBS were recruited from a university in southern Ontario, Canada. Each woman completed a background questionnaire, an e-mail interview, and a face-to-face interview. These data were subsequently analyzed for trends using phenomenology to direct the analysis.

RESULTS

Women reported using a number of strategies to help them cope with their diagnosis of IBD or IBS: positive attitude, support, controlling the situation and surroundings, distraction/ignoring the problem, relaxation techniques, and education/knowledge.

CONCLUSIONS

This research enables women to share their experiences concerning their coping strategies used in the management of IBD and/or IBS. The qualitative nature of this study provides the "voice" of women who have a GI disorder, which is often lacking in the literature, thus providing healthcare professionals with insight into the feelings and experiences of these women. The inability to understand the experiences of individuals with chronic conditions can act as a barrier in the treatment and interaction/rapport between healthcare professional and client.

"I know this is bad for me, but...": a qualitative investigation of women with irritable bowel syndrome and inflammatory bowel disease: part II

INTRODUCTION

Individuals with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) experience similar symptoms; however, individuals with IBD have alterations in their digestive tract and an increased probability of developing colorectal cancer, whereas individuals with IBS do not. Although not well documented within the literature, individuals with gastrointestinal (GI) disorders may engage in adverse behaviors regarding their intake of food, regardless of the fact that the "offending agents" have been identified. Further study into these negative behaviors is warranted for healthcare professionals to be provided with a better understanding of the behaviors that individuals with GI disorders knowingly engage in, despite the negative consequences.

PURPOSE

The overall objective of this research was to explore the lived experience of women diagnosed with the GI disorders IBD and/or IBS, with an emphasis on the dietary patterns of the women before and after diagnosis. Specifically, this article examines the adverse behaviors that women engaged in with respect to the consumption of food, beverages, and medications.

METHODS

Eight women diagnosed with IBD or IBS were recruited from a university campus in southwestern Ontario, Canada. Participants completed a background questionnaire, a 14-day food diary, and a semistructured interview consisting of 8 open-ended questions.

RESULTS

Three major themes were identified: family and friend support, control, and adverse behaviors. The focus of this article, the theme of adverse behaviors, consisted of 2 major subthemes: dietary restrictions and issues with medication. All women engaged in adverse behaviors regarding their food intake and/or consumption of medications as related to food intake.

CONCLUSIONS

Semistructured interviews with women diagnosed with IBD and IBS revealed that all women felt governed by their bowels to varying degrees. In addition, all women within this sample knowingly engaged in behaviors concerning food/beverages that had the potential to be detrimental to their conditions. A myriad of reasons were given for consuming foods/beverages. Implications for nursing practitioners are discussed.

Seeking control through the determination of diet: a qualitative investigation of women with irritable bowel syndrome and inflammatory bowel disease

PURPOSE

The overall objective of this investigation was to study the lived experience, in relation to diet, of women who have been diagnosed with Inflammatory Bowel Disease and/or Irritable Bowel Syndrome. This study specifically explored pre-illness and postdiagnosis dietary patterns of participants with an emphasis on the changes, if any, that participants had made to their diet.

METHODS

This study took place on a university campus in southwestern Ontario, Canada. Eight women between the ages of 18 and 23 years were recruited. Participants completed a consent form, background questionnaire, and a 14-day food diary. Participant also engaged in one-on-one semistructured interviews that consisted of 8 open-ended questions aimed at gaining a thorough understanding of the lived experience of these women, with respect to their dietary practices.

RESULTS

The 3 major themes identified included: control; family and friend support; and adverse behaviors. The salient theme of control included the subthemes timing and awareness of surroundings, giving into temptations, and determination of diet. Determining one's diet, the subtheme that is addressed in this article, involved several key elements, including (1) the role of the physician(s), (2) experimentation, (3) seeking information, and (4) food modifications.

CONCLUSIONS

Diet was the primary behavioral factor manipulated by participants to manage their conditions. The determination of potential trigger foods/beverages, however, entailed an often frustrating process of trial and error, in which few of the women received assistance from primary healthcare professionals. As a result, many of the women sought dietary information from alternate sources, some of which may not provide reliable information. Through experimentation and, for some, the documentation of food intake and symptom production, all participants identified food/beverage items they believed to cause symptom development. Although similar items were identified by many, all participants had individual triggers and sensitivities.

Women with irritable bowel syndrome and their perception of a good quality of life

Irritable bowel syndrome has a negative impact on a person's quality of life, but only a few existing studies have been based on patients' own perceptions. This study therefore aimed to collect information on the view of female patients with irritable bowel syndrome regarding what constitutes a good quality of life for them and to create a healthcare model for these patients. For the study, 30 women with irritable bowel syndrome (median age, 38.5 years; range, 20-65 years) responded in writing to a single, all-inclusive question: "What is your perception of a good quality of life?" When the questionnaires were returned, there was time for a short dialogue, and notes of the conversations were made. Data were analyzed qualitatively according to Burnard's method of thematic content analysis. The answers also were counted and thereby quantified. The women's perception of a good quality of life could be divided into five categories: (a) physical and mental health, (b) social well-being, (c) welfare, (d) strength and energy, and (e) self-fulfillment. According to the results, a healthcare model for patients with irritable bowel syndrome should include four main areas: (a) treatment of the patient's symptoms, (b) confirmation of the patient, (c) confirmation of the diagnosis, and (d) instruction for the patient. The healthcare model should be focused on the primary care level and should include a longitudinal plan of healthcare that also describes the secondary care level.

Different autonomic responses to experimental pain in IBS patients and healthy controls

BACKGROUND

Pain perception ratings in irritable bowel syndrome (IBS) patients suggest that they present either hypoalgesia or hyperalgesia. However, little is known about the physiologic responses these patients present to a somatic painful stimulus.

GOALS

The main goal of this project was to study autonomic nervous system responses and the cardiac response to experimental pain in IBS patients.

STUDY

This was addressed by exposing 27 women, 14 IBS, and 13 healthy controls (HCs), to a cold water (7 degrees C) immersion test of the forefoot for 2 minutes. Pain perception, galvanic skin responses (GSR), and heart rate (HR) were monitored during and after the immersion.

RESULTS

For comparable pain perception, a significant group difference (P<0.02) in the cardiac response was observed during the immersion where the peak rise in HR was much higher for HCs, reaching 22%, whereas it only reached 8% for IBS patients. Moreover, HR variability analysis demonstrated that IBS and HCs had opposite autonomic cardiac reactivity to pain, where IBS had increased parasympathetic/decreased sympathetic reactivity.

CONCLUSIONS

For comparable pain perception, IBS subject demonstrated different autonomic nervous system response to pain, which supports the view of autonomic dysregulation in IBS.