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Risk factors support biopsychosocial model of IBS
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The results of a prospective cohort study showed that — in addition to acute gastrointestinal infection — female sex, vulnerability to diarrhea under stress, previous diarrhea, subjective somatic symptom burden and illness anxiety are all independently associated with the risk for developing irritable bowel syndrome.
Investigators concluded these results support a biopsychosocial model of IBS development and that somatic and psychological factors should be addressed in the prevention, diagnosis and treatment of IBS.
Bernd Löwe
“This study investigates predictors of the development of [IBS] in a unique, community-based sample. The interdisciplinary team of authors overcame many of the limitations of previous studies by investigating a large cohort of healthy individuals at risk of developing gastrointestinal infections before being infected, and in doing so, have realistic measurements of premorbid risk factors of IBS development,” Bernd Löwe, MD, of the department of psychosomatic medicine and psychotherapy at University Medical Center Hamburg-Eppendorf and Schön Klinik Hamburg-Eilbek in Hamburg, Germany, told Healio Gastroenterology.
Between January 2011 and September 2012, Löwe and colleagues recruited 1,964 adults from a vaccination and travel advice clinic who were preparing for a long distance journey. They evaluated potential IBS predictors using validated self-report scales before participants left for their trip, a week after they returned (n = 1,464) and 7 months after they returned (n = 1,190; 52.8% women; mean age, 39.9 years; mean trip length, 40.8 days).
At least moderate infectious traveler’s diarrhea was reported by 43.3% of study completers, and by 7 months, 7.2% developed IBS symptoms.
“Results of the carefully designed multivariate data analyses provide evidence for a biopsychosocial model of IBS-development: acute gastrointestinal infection, female [sex], vulnerability to diarrhea under stress, previous diarrhea, subjective somatic symptom burden, and illness anxiety were identified as independent predisposing factors for IBS development,” Löwe said. “Based on these results, it is now unambiguously clear that both psychological and somatic components of the disease must be addressed in treatment, prevention, and education strategies.”
Future studies on the underlying mechanisms of these risk factors are warranted, the investigators wrote. – by Adam Leitenberger
Disclosures: One of the researchers reports she has received speaker and/or consulting fees from Almirall, Allergan, AstraZeneca, Boehringer Ingelheim, Falk, Schwabe, Shire and Yakult.
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