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Altered psychobiological responsiveness in women with irritable bowel syndrome.
Psychosom Med 2012 Feb-Mar; 74(2):221-31PM

Abstract

OBJECTIVE

Although stress has been considered an important pathophysiological factor in irritable bowel syndrome (IBS), there is incomplete understanding of its physiological mechanisms. The current study was designed to compare diurnal hypothalamic-pituitary-adrenal (HPA) axis activity in IBS patients and controls and their psychobiological response to a psychosocial stressor.

METHODS

Basal and stimulated HPA axis activity was assessed in 57 women with IBS and 20 matched controls. Psychiatric comorbidity was assessed using a standardized clinical interview. Salivary morning cortisol and diurnal profile were obtained, and the Trier Social Stress Test (TSST) was administered. Levels of cortisol and adrenocorticotropic hormone (ACTH) were measured before and within 1 hour after the stressor. Overall stress experience and stress related to the TSST were assessed using standardized questionnaires.

RESULTS

All subjects showed intact circadian variation of cortisol. However, IBS patients with predominant diarrhea exhibited substantially heightened cortisol levels at awakening (p < .03) and a blunted cortisol awakening response. In response to the TSST, patients exhibited significantly blunted cortisol (p < .05) and slightly attenuated ACTH secretion compared with controls. During the recovery period, ACTH levels were significantly lower (p < .04) in patients than those in healthy subjects. Women with IBS perceived higher stress susceptibility than control subjects did (p < .01).

CONCLUSIONS

The enhanced morning cortisol levels in one subgroup of IBS patients may indicate an association between basal HPA axis activity and predominant bowel habit. The downregulated HPA axis reactivity in IBS after the TSST suggests a downregulated sensitivity of the endocrine system. On the contrary, all subjective stress ratings were increased in the IBS group, which may indicate increased stress susceptibility.

Authors+Show Affiliations

Institute of Psychology, University of Zurich, Zurich, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22286854

Citation

Suárez-Hitz, Kerstin A., et al. "Altered Psychobiological Responsiveness in Women With Irritable Bowel Syndrome." Psychosomatic Medicine, vol. 74, no. 2, 2012, pp. 221-31.
Suárez-Hitz KA, Otto B, Bidlingmaier M, et al. Altered psychobiological responsiveness in women with irritable bowel syndrome. Psychosom Med. 2012;74(2):221-31.
Suárez-Hitz, K. A., Otto, B., Bidlingmaier, M., Schwizer, W., Fried, M., & Ehlert, U. (2012). Altered psychobiological responsiveness in women with irritable bowel syndrome. Psychosomatic Medicine, 74(2), pp. 221-31. doi:10.1097/PSY.0b013e318244fb82.
Suárez-Hitz KA, et al. Altered Psychobiological Responsiveness in Women With Irritable Bowel Syndrome. Psychosom Med. 2012;74(2):221-31. PubMed PMID: 22286854.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altered psychobiological responsiveness in women with irritable bowel syndrome. AU - Suárez-Hitz,Kerstin A, AU - Otto,Bärbel, AU - Bidlingmaier,Martin, AU - Schwizer,Werner, AU - Fried,Michael, AU - Ehlert,Ulrike, Y1 - 2012/01/27/ PY - 2012/1/31/entrez PY - 2012/1/31/pubmed PY - 2012/5/23/medline SP - 221 EP - 31 JF - Psychosomatic medicine JO - Psychosom Med VL - 74 IS - 2 N2 - OBJECTIVE: Although stress has been considered an important pathophysiological factor in irritable bowel syndrome (IBS), there is incomplete understanding of its physiological mechanisms. The current study was designed to compare diurnal hypothalamic-pituitary-adrenal (HPA) axis activity in IBS patients and controls and their psychobiological response to a psychosocial stressor. METHODS: Basal and stimulated HPA axis activity was assessed in 57 women with IBS and 20 matched controls. Psychiatric comorbidity was assessed using a standardized clinical interview. Salivary morning cortisol and diurnal profile were obtained, and the Trier Social Stress Test (TSST) was administered. Levels of cortisol and adrenocorticotropic hormone (ACTH) were measured before and within 1 hour after the stressor. Overall stress experience and stress related to the TSST were assessed using standardized questionnaires. RESULTS: All subjects showed intact circadian variation of cortisol. However, IBS patients with predominant diarrhea exhibited substantially heightened cortisol levels at awakening (p < .03) and a blunted cortisol awakening response. In response to the TSST, patients exhibited significantly blunted cortisol (p < .05) and slightly attenuated ACTH secretion compared with controls. During the recovery period, ACTH levels were significantly lower (p < .04) in patients than those in healthy subjects. Women with IBS perceived higher stress susceptibility than control subjects did (p < .01). CONCLUSIONS: The enhanced morning cortisol levels in one subgroup of IBS patients may indicate an association between basal HPA axis activity and predominant bowel habit. The downregulated HPA axis reactivity in IBS after the TSST suggests a downregulated sensitivity of the endocrine system. On the contrary, all subjective stress ratings were increased in the IBS group, which may indicate increased stress susceptibility. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/22286854/Altered_psychobiological_responsiveness_in_women_with_irritable_bowel_syndrome_ L2 - http://Insights.ovid.com/pubmed?pmid=22286854 DB - PRIME DP - Unbound Medicine ER -