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Quek SXZ, Loo EXL, Demutska A, Chua CE, Kew GS, Wong S, Lau HX, Low EXS, Loh TL, Lung OS, Hung ECW, Rahman MM, Ghoshal UC, Wong SH, Cheung CKY, Syam AF, Tan N, Xiao Y, Liu J, Lu F, Chen C, Lee YY, Maralit RM, Kim Y, Oshima T, Miwa H, Pang J, Siah KTH. Impact of the coronavirus disease 2019 pandemic on irritable bowel syndrome. J Gastroenterol Hepatol 2021; 36:2187-2197. [PMID: 33615534 PMCID: PMC8014795 DOI: 10.1111/jgh.15466] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/18/2021] [Accepted: 02/14/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM Gastrointestinal manifestations of the coronavirus disease 2019 (COVID-19) pandemic may mimic irritable bowel syndrome (IBS), and social distancing measures may affect IBS patients negatively. We aimed to study the impact of COVID-19 on respondents with self-reported IBS. METHODS We conducted an anonymized survey from May to June 2020 in 33 countries. Knowledge, attitudes, and practices on personal hygiene and social distancing as well as psychological impact of COVID-19 were assessed. Statistical analysis was performed to determine differences in well-being and compliance to social distancing measures between respondents with and without self-reported IBS. Factors associated with improvement or worsening of IBS symptoms were evaluated. RESULTS Out of 2704 respondents, 2024 (74.9%) did not have IBS, 305 (11.3%) had self-reported IBS, and 374 (13.8%) did not know what IBS was. Self-reported IBS respondents reported significantly worse emotional, social, and psychological well-being compared with non-IBS respondents and were less compliant to social distancing measures (28.2% vs 35.3%, P = 0.029); 61.6% reported no change, 26.6% reported improvement, and 11.8% reported worsening IBS symptoms. Higher proportion of respondents with no change in IBS symptoms were willing to practice social distancing indefinitely versus those who deteriorated (74.9% vs 51.4%, P = 0.016). In multivariate analysis, willingness to continue social distancing for another 2-3 weeks (vs longer period) was significantly associated with higher odds of worsening IBS. CONCLUSION Our study showed that self-reported IBS respondents had worse well-being and compliance to social distancing measures than non-IBS respondents. Future research will focus on occupational stress and dietary changes during COVID-19 that may influence IBS.
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Affiliation(s)
- Sabrina Xin Zi Quek
- Department of Medicine, Yong Loo Lin School of MedicineNational University HospitalSingapore
| | - Evelyn Xiu Ling Loo
- Department of Paediatrics, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,Singapore Institute for Clinical SciencesAgency for Science, Technology and ResearchSingapore
| | - Alla Demutska
- Department of Clinical PsychologyJames Cook UniversitySingapore
| | - Chun En Chua
- Department of Medicine, Yong Loo Lin School of MedicineNational University HospitalSingapore
| | - Guan Sen Kew
- Department of Medicine, Yong Loo Lin School of MedicineNational University HospitalSingapore,Division of Gastroenterology and Hepatology, Department of MedicineNational University HospitalSingapore
| | - Scott Wong
- Department of MedicineNg Teng Fong General HospitalSingapore
| | - Hui Xing Lau
- Singapore Institute for Clinical SciencesAgency for Science, Technology and ResearchSingapore
| | | | - Tze Liang Loh
- Department of Otorhinolarygology, Head and Neck SurgeryUniversiti Putra MalaysiaSeri KembanganMalaysia
| | - Ooi Shien Lung
- Department of AnaesthesiologyColumbia Asia HospitalMiriSarawakMalaysia
| | | | - M. Masudur Rahman
- Department of GastroenterologySheikh Russel National Gastroliver Institute and HospitalDhakaBangladesh
| | - Uday C Ghoshal
- Department of GastroenterologySanjay Gandhi Postgraduate Institute Medical ScienceLucknowIndia
| | - Sunny H Wong
- Department of Medicine and Therapeutics, Faculty of MedicineThe Chinese University of Hong KongShatinHong Kong
| | - Cynthia K Y Cheung
- State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong,Department of MedicineThe University of Hong KongHong Kong
| | - Ari F Syam
- Division of Gastroenterology, Department of Internal Medicine, Faculty of MedicineUniversity of Indonesia/Cipto Mangunkusumo HospitalJakartaIndonesia
| | - Niandi Tan
- Departments of Gastroenterology and HepatologyThe First Affiliated Hospital, Sun Yat‐sen UniversityGuangzhouChina
| | - Yinglian Xiao
- Departments of Gastroenterology and HepatologyThe First Affiliated Hospital, Sun Yat‐sen UniversityGuangzhouChina
| | - Jin‐Song Liu
- Department of GastroenterologyWuhan Union Hospital of Huazhong University of Science and TechnologyWuhanHubeiChina
| | - Fang Lu
- Xiyuan Hospital, China Academy of Chinese Medical SciencesBeijingChina
| | - Chien‐Lin Chen
- Department of MedicineBuddhist Tzu Chi Hospital and University School of MedicineHualienTaiwan
| | - Yeong Yeh Lee
- St George and Sutherland Clinical SchoolUniversity of New South WalesSydneyNew South WalesAustralia,Gut Research Group, Faculty of MedicineUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia
| | | | - Yong‐Sung Kim
- Wonkwang Digestive Disease Research Institute, Gut and Food HealthcareWonkwang University School of MedicineIksanSouth Korea
| | - Tadayuki Oshima
- Division of Gastroenterology and Hepatology, Department of Internal MedicineHyogo College of MedicineNishinomiyaHyogoJapan
| | - Hiroto Miwa
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingapore
| | - Junxiong Pang
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingapore,Centre for Infectious Disease Epidemiology and ResearchNational University of SingaporeSingapore
| | - Kewin Tien Ho Siah
- Department of Medicine, Yong Loo Lin School of MedicineNational University HospitalSingapore,Division of Gastroenterology and Hepatology, Department of MedicineNational University HospitalSingapore
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Kutschke J, Harris JR, Bengtson M. How are perceptions of social strain and low support related to Irritable Bowel Syndrome?-A Norwegian twin study. Neurogastroenterol Motil 2021; 33:e14007. [PMID: 33030285 PMCID: PMC8047927 DOI: 10.1111/nmo.14007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 08/28/2020] [Accepted: 09/14/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Social stress is related to symptom burden of irritable bowel syndrome (IBS). This study explores the associations between IBS and social strain or low support in close relationships, including spouse, friends, and family, in a Norwegian twin cohort. METHODS The sample included 5442 Norwegian twins aged 40-80, of whom 589 suffer from IBS. We used multivariate structural equation models to estimate genetic and environmental sources of variation and covariation underlying IBS liability, measures of social stress and the relationships between these. The co-twin control design was used to explore the nature of the associations between IBS and social strain or low support using models that test for causality. KEY RESULTS Genetic effects explained between 30% and 40% of the variation in IBS liability, social strain, and low support. The phenotypic correlations between IBS and social strain (0.20) and between IBS and low support (0.17) were primarily explained by shared genetic pathways. Surprisingly, all the genetic variation underlying the liability to develop IBS was shared with genetic influences underlying social strain and low support. In contrast, most of the nonshared environmental influences accounting for the variation of IBS risk were unique for IBS. The co-twin control analyses suggest that the relationships between IBS and the social measures reflect shared familial rather than causal effects. CONCLUSION & INFERENCES The genetic variation of IBS risk was fully shared with genetic effects for variation in the social measures, emphasizing the contribution of genes involved in central brain-gut mechanisms to genetic variation in IBS risk.
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Affiliation(s)
| | - Jennifer R. Harris
- Division of Health Data and DigitalisationThe Norwegian Institute of Public HealthOsloNorway
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Sabate JM, Deutsch D, Melchior C, Entremont A, Mion F, Bouchoucha M, Façon S, Raynaud JJ, Zerbib F, Jouët P. COVID-19 pandemic and lockdown stress consequences in people with and without Irritable Bowel Syndrome. ACTA ACUST UNITED AC 2021; 18:100660. [PMID: 34150971 PMCID: PMC8206631 DOI: 10.1016/j.jemep.2021.100660] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/21/2021] [Indexed: 12/19/2022]
Abstract
Background While all resources have been mobilized to fight COVID-19, this study aimed to analyze the consequences of lockdown and pandemic stress in participants with and without Irritable Bowel Syndrome (IBS). Methodology An online survey was proposed to people with or without IBS during the exponential phase of the pandemic in France. The questionnaire included questions about socio-demographic data, conditions of confinement, activities carried out, IBS characteristics, measurement of stress level, consequences on sleep, fatigue, anxiety and depression, and quality of life (both perceived non-specific and specific for IBS). Results/Discussion From March 31 to April 15, 2020, 304 participants, 232 with IBS and 72 without were included in the survey (mean age: 46.8 ± 16.8 years, female gender: 75.3%). Age, level of education, financial resources, living space per person and activities performed during confinement were identical in both groups. Stress linked to fear of COVID-19, lockdown and financial worries was at the same level in both groups, but the psychological consequences and deterioration of quality of life (QOL) were both higher in IBS participants. In a univariate analysis, teleworking, solitary confinement, and low household resources had a variable impact on the scores of depression, anxiety, fatigue and non-specific perceived QOL, but in a multivariate analysis, the only factor explaining a deterioration of non-specific QOL was the fact of suffering from IBS. Conclusion/Perspectives Stress linked to the COVID-19 pandemic and confinement is high and equivalent in both IBS and non-IBS participants, with higher psychological and QOL consequences in IBS patients who have altered coping capacities.
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Affiliation(s)
- J-M Sabate
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France.,INSERM U-987, Pathophysiology and Clinical Pharmacology of pain, Ambroise-Paré Hospital, 92100 Boulogne-Billancourt, France
| | - D Deutsch
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France
| | - C Melchior
- Gastroenterology Department and INSERM CIC-CRB 1404, Rouen University Hospital and INSERM UMR 1073, Institute for Research and Innovation in Biomedicine, Normandy University, 76031 Rouen, France
| | - A Entremont
- 28, place du marché Saint-Honoré, 75001 Paris, France
| | - F Mion
- Gastroenterology Department, hôpital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon, France
| | - M Bouchoucha
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France
| | - S Façon
- Association des patients souffrant du syndrome de l'intestin irritable (APSSII, www.apsssi.org), hôpital Avicenne, 125, rue de Stalingrad, Bobigny, France
| | - J-J Raynaud
- Gastroenterology Department, hôpital Avicenne, Paris 13 Nord, AP-HP, 125, rue de Stalingrad, Bobigny, France
| | - F Zerbib
- Gastroenterology Department, hôpital Haut-Lévêque, 1, avenue Magellan, 33604 Pessac cedex, France
| | - P Jouët
- INSERM U-987, Pathophysiology and Clinical Pharmacology of pain, Ambroise-Paré Hospital, 92100 Boulogne-Billancourt, France.,Gastroenterology Department, hôpital Ambroise-Paré, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
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Huerta PA, Cifuentes M, Levenstein C, Kriebel D. The Association of Occupational Psychosocial Factors with the Prevalence of Irritable Bowel Syndrome in the Chilean Working Population. Ann Work Expo Health 2020; 63:426-436. [PMID: 30877302 DOI: 10.1093/annweh/wxz017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 02/09/2019] [Accepted: 02/17/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a stress-related disease linked to psychosocial factors, though knowledge about its occupational psychosocial aspects is scarce. OBJECTIVE A cross-sectional study of the prevalence of IBS and its association with occupational psychosocial factors in Chilean workers was conducted. METHODS IBS prevalence, using the IBS-Rome IV criteria, in the working population was estimated using data from the National Health Survey of 2009. Data on occupational psychosocial aspects were drawn from the Chilean Survey of Employment, Health, and Work of 2009, and allocated to individual survey participants at the occupation-region level. Data on family and community stressors were available at the individual level. Prevalence ratios (PR) for IBS were computed using generalized linear mixed models to account for variability at the group level. RESULTS The IBS prevalence in the overall working population (weighted n = 5 435 253) was 18.4%, but varied substantially by industry sector. Compared with 'professionals' (IBS prevalence = 7.3%), jobs with high prevalence of IBS included 'health and social work activities' [PR = 4.9; 95% confidence interval (CI) = 1.4-16.7], 'household employment' (PR = 4.8; 95% CI = 1.5-15.9), and 'manufacturing' (PR = 3.5; 95% CI = 1.0-11.8). With Karasek Job Demand Control scores assigned to occupations within regions, high job demand doubled the prevalence of IBS (PR = 2.0; 95% CI = 1.4-2.9), whereas high-skill discretion was associated with lower prevalence of IBS (PR = 0.6; 95% CI = 0.4-0.8). There was also evidence that these two factors were not independent; high-skill discretion appeared to buffer the effect of high job demand on IBS prevalence (P < 0.001). CONCLUSIONS Occupational factors were associated with IBS prevalence, showing effects as important as those for non-occupational stresses such as civic insecurity or having health problems. High job skill discretion appeared to reduce the prevalence of IBS in the presence of high job demands. Given its high overall prevalence and poorly understood risk factors, further research on occupational psychosocial factors of IBS is warranted.
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Affiliation(s)
- Patricia A Huerta
- Departamento de Salud Pública, Universidad de Concepción, Concepción, Chile
| | | | - Charles Levenstein
- Department of Public Health, University of Massachusetts Lowell, Lowell MA, USA
| | - David Kriebel
- Department of Public Health, University of Massachusetts Lowell, Lowell MA, USA
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Li YJ, Dai C, Jiang M. Mechanisms of Probiotic VSL#3 in a Rat Model of Visceral Hypersensitivity Involves the Mast Cell-PAR2-TRPV1 Pathway. Dig Dis Sci 2019; 64:1182-1192. [PMID: 30560330 DOI: 10.1007/s10620-018-5416-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Mast cells (MCs), PAR2 and TRPV1, play a key role in the regulation of visceral pain. Several studies have found that probiotics regulate visceral sensitivity. AIMS The purpose of the current study was to explore the role of MC-PAR2-TRPV1 in VH and the mechanism of VSL#3 in a rat model of VH. METHODS A total of 64 rats were randomly divided into eight groups: Control VH, VH + ketotifen, VH + FSLLRY-NH2, VH + SB366791, VH + VSL#3, VH + VSL#3 + capsaicin, and VH + VSL#3 + SLIGRL-NH2. The rat model of VH was induced by acetic acid enema and the partial limb restraint method. VH was assessed by the abdominal withdrawal reflex score. MCs in colonic tissue were detected by the toluidine blue staining assay. The expression of PAR2 and TRPV1 in DRGs (L6-S1) was measured by immunohistochemistry and Western blotting. RESULTS The established VH was abolished by treatment with ketotifen, a mast cell stabilizer FSLLRY-NH2, a PAR2 antagonist SB366791 a TRPV1 antagonist, and probiotic VSL#3 in rats. The administration of ketotifen or probiotic VSL#3 caused a decrease in mast cell number in the colon and decreased PAR2 and TRPV1 expression in DRGs. Intrathecal injection of FSLLRY-NH2 or SB366791 caused decreased expression of PAR2 and/or TRPV1 in DRGs in VH rats. SLIGRL-NH2, a PAR2 agonist, and capsaicin, a TRPV1 agonist, blocked the effects of probiotic VSL#3. CONCLUSIONS The probiotic VSL#3 decreases VH in rat model of VH. The mechanism may be related with the mast cell-PAR2-TRPV1 signaling pathway.
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Affiliation(s)
- Ying-Jie Li
- Department of Gastroenterology, First Affiliated Hospital, China Medical University, No. 92 of Beier Road, Heping District, Shenyang City, 110001, Liaoning Province, China
| | - Cong Dai
- Department of Gastroenterology, First Affiliated Hospital, China Medical University, No. 92 of Beier Road, Heping District, Shenyang City, 110001, Liaoning Province, China.
| | - Min Jiang
- Department of Gastroenterology, First Affiliated Hospital, China Medical University, No. 92 of Beier Road, Heping District, Shenyang City, 110001, Liaoning Province, China.
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Roohafza H, Keshteli AH, Daghaghzadeh H, Afshar H, Erfani Z, Adibi P. Life stressors, coping strategies, and social supports in patients with irritable bowel syndrome. Adv Biomed Res 2016; 5:158. [PMID: 27761433 PMCID: PMC5070037 DOI: 10.4103/2277-9175.190935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 02/29/2016] [Indexed: 12/13/2022] Open
Abstract
Background: The frequency and the perceived intensity of life stressors, coping strategies, and social supports are very important in everybody's well-being. This study intended to estimate the relation of irritable bowel syndrome (IBS) and these factors. Materials and Methods: This was a cross-sectional study carried out in Isfahan on 2013. Data were extracted from the framework of the study on the epidemiology of psychological, alimentary health, and nutrition. Symptoms of IBS were evaluated by Talley bowel disease questionnaire. Stressful life event, modified COPE scale, and Multidimensional Scale of Perceived Social Support were also used. About 4763 subjects were completed questionnaires. Analyzing data were done by t-test and multivariate logistic regression. Results: Of all returned questionnaire, 1024 (21.5%) were diagnosed with IBS. IBS and clinically-significant IBS (IBS-S) groups have significantly experienced a higher level of perceived intensity of stressors and had a higher frequency of stressors. The mean score of social supports and the mean scores of three coping strategies (problem engagement, support seeking, and positive reinterpretation and growth) were significantly lower in subjects with either IBS-S or IBS than in those with no IBS. Multivariate logistic regression revealed a significant association between frequency of stressors and perceived intensity of stressors with IBS (odds ratio [OR] =1.09 and OR = 1.02, respectively) or IBS-S (OR = 1.09 and OR = 1.03, respectively). Conclusions: People with IBS had higher numbers of stressors, higher perception of the intensity of stressors, less adaptive coping strategies, and less social supports which should be focused in psychosocial interventions.
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Affiliation(s)
- Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan, Iran
| | - Ammar Hassanzadeh Keshteli
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Daghaghzadeh
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Afshar
- Psychosomatic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Erfani
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Koh SJ, Kim M, Oh DY, Kim BG, Lee KL, Kim JW. Psychosocial stress in nurses with shift work schedule is associated with functional gastrointestinal disorders. J Neurogastroenterol Motil 2014; 20:516-22. [PMID: 25230903 PMCID: PMC4204411 DOI: 10.5056/jnm14034] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/15/2014] [Accepted: 05/17/2014] [Indexed: 12/13/2022] Open
Abstract
Background/Aims The aim of this study was to investigate the role of psychosocial problems and their associations with rotating shift work in the development of functional gastrointestinal disorders. Methods In this cross-sectional observation study, survey was administered to nurses and nurse assistants in a referral hospital. In addition to demographic questions, subjects were asked to complete the Rome III Questionnaire, Pittsburgh Sleep Quality Index and Rome III Psychosocial Alarm Questionnaire. Results Responses from 301 subjects were assessed. The overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 15.0% and 19.6%, respectively. Psychosocial alarms were prevalent in the nursing personnel (74.8% with alarm presence and 23.3% with serious condition) and were more frequent among rotating shift workers (84.7% vs. 74.5% for alarm presence and 28.1% vs. 13.3% for serious condition). The prevalence of both IBS and FD significantly increased with psychosocial risk. An independent risk factor for IBS was serious psychosocial alarm (adjusted odds ratio [aOR], 10.75; 95% confidence interval (CI), 1.30–88.99; P = 0.028). Serious psychosocial alarm was an independent risk factor for FD (aOR, 7.84; 95% CI, 1.98–31.02; P = 0.003). Marriage (aOR 0.30; 95% CI, 0.09–0.93; P = 0.037) was associated with the decreased risk of FD. Conclusions The high prevalence of psychosocial stress among nurses who work rotating shifts is associated with the development of functional gastrointestinal disorders.
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Affiliation(s)
- Seong-Joon Koh
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Mingoo Kim
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Da Yeon Oh
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Byeong Gwan Kim
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kook Lae Lee
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Won Kim
- Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
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