Does Stress Influence Inflammatory Bowel Disease? The Clinical Data

Rampton, David

doi:10.1159/000268124

Cited by 30 publications

(24 citation statements)

References 53 publications

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“…7 An increasing number of well-designed large-scale investigations provide evidence that psychological factors are linked to the course of IBD, especially chronic stress in UC and depressive symptoms in CD. 8,9 Despite the uncertainty from the available studies, interestingly, over 50% of patients with IBD "believe" that psychological factors play a major role in the course of their disease. 9,10 Nevertheless, patients evidently define the disease course based on perceived symptoms and not on the degree of intestinal inflammation.…”

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confidence: 99%

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Schreiner

Biedermann

Rossel

et al. 2017

Inflammatory Bowel Diseases

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BACKGROUND Psychosocial factors have been shown to predict a poor disease course in patients with inflammatory bowel disease (IBD), but whether this applies to job stress is currently unknown. We assessed the prevalence of job stress and its correlates in a large cohort of patients with IBD. METHODS We included all adult, professionally active patients enrolled between 2006 and 2015 in the Swiss IBD Cohort. Job stress was measured through the self-report effort-reward imbalance ratio and overcommitment (OC) to work questionnaires. We used multiple linear regressions to assess association with sociodemographic, lifestyle, psychosocial, and disease-related factors. RESULTS Altogether 1656 patients completed the questionnaires (905 Crohn's disease and 751 ulcerative colitis/IBD unclassified). Only 91 (5.7%) of patients had an effort-reward imbalance ratio >1. Effort-reward imbalance and OC scores were higher in full-time versus part-time employees (coef = 0.050, P = 0.002; coef = 0.906, P < 0.001) and among those absent from the workplace in the previous 3 months (coef = 0.049, P = 0.010; coef = 1.062, P < 0.001). Higher OC scores were associated with sex (women vs. men: coef = 0.568, P = 0.014), being in a relationship (coef = 0.805, P = 0.001), higher level of occupation (director vs. trainee: coef = 1.447, P < 0.001), and extraintestinal manifestations (coef = 0.623, P = 0.005). Patients hospitalized in the previous 12 months had lower OC scores (coef = 0.560, P = 0.038). CONCLUSIONS The average level of job stress seems to be remarkably low in patients with IBD from Switzerland. The clinician should turn attention especially to women, full-time employees with a high level of education, and patients with extraintestinal manifestations to identify those with the most vulnerability to suffer from job stress.

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confidence: 99%

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Schreiner

Biedermann

Rossel

et al. 2017

Inflammatory Bowel Diseases

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“…6 Its cause remains unclear, with a complex interaction of genetics and environmental factors thought to play a part. 1 IBD impacts on psychological well-being and quality of life, [7][8][9][10][11][12][13] and can be diagnosed at any age, with onset usually between 15 and 35 years of age, 14 and around a quarter of cases diagnosed under the age of 20 years. 15 Presentation of IBD in young people differs from adult onset, with more extensive distribution and severity of disease in children.…”

Section: Introductionmentioning

confidence: 99%

Transitioning patients with inflammatory bowel disease (IBD) from adolescent to adult services: a systematic review

Clarke

Lusher

2015

Frontline Gastroenterol

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Approximately a quarter of patients with inflammatory bowel disease (IBD) are diagnosed before 20 years of age, presenting with more extensive distribution and severity of disease than adult onset. The purpose of this review was to determine facilitators of, and barriers to, successful transition of patients with IBD from adolescent to adult services. A systematic review of IBD transition research was conducted in March 2014 searching PubMed, MEDLINE, PsycINFO, Web of Science and the Cochrane Database of Systematic Reviews databases. A hand search of reference lists and narrative reviews was carried out to maximise the potential for retrieving all relevant manuscripts. Primary studies written in English of full-length peerreviewed journal articles that investigated transition of paediatric patients with IBD to adult services were included. Studies were excluded if the primary focus was not IBD. The search produced 283 potentially relevant studies. After removing duplicates and screening for suitability, six met our inclusion criteria. Barriers to transition included system inadequacies and a lack of resources, clinical time and training. Successful transition involved joint medical visits, structured transition services, improved communication between paediatric and adult services and improved education for patients and staff. If the transition process for adolescents suffering with IBD is to improve then it is vital that more research is conducted to better our understanding of ways in which we can ensure that defined protocols are in place for a smooth transition for every adolescent, leading to improved standards and minimal disruption to care. BACKGROUNDInflammatory bowel disease (IBD) is a group of inflammatory conditions of the

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“…Gleichzeitig scheinen aber auch Stress und belastende Lebensereignisse den Verlauf der chronisch entzündlichen Darmerkrankungen zu beeinflussen. In einer Übersichtsarbeit fasst Rampton [2009] [Pavlov und Tracey, 2012]. -HPA-Achse: Stress erhöht die Mukosa-Permeabilität des Colons bei Ratten über einen CRF-abhängigen Mechanismus, bei dem vermehrt der entzündungsfördernde Tumornekrosefaktor (TNF) freigesetzt wird [Yuan et al, 2012].…”

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Grundkonzepte der gastrointestinalen Psychophysiologie

Cuntz

2014

Verhaltenstherapie

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Die wissenschaftliche Beschäftigung mit der Psychophysiologie des Gastrointestinaltrakts hat mittlerweile eine lange Tradition und hat zu beachtlichen Ergebnissen geführt. Dabei haben sich die Grundkonzepte und Forschungsansätze in den letzten 50 Jahren erheblich gewandelt, weisen dabei aber doch eine bemerkenswerte Konvergenz auf. Der Gastrointestinaltrakt reagiert auf unterschiedliche Stressoren mit unterschiedlichen Motilitätsmustern; verschiedene Abschnitte des Gastrointestinaltrakts können dabei in unterschiedlicher, gegebenenfalls auch gegensinniger Weise reagieren. Es gibt Hinweise, aber keine zweifelsfreien Belege dafür, dass unterschiedliche Emotionen mit unterschiedlichen Reaktionsmustern assoziiert sind. Entgegen der ursprünglichen Annahme gibt es keinen eindeutigen Zusammenhang zwischen Motilitätsmustern und gastrointestinalen Beschwerden. Das Reizdarmsymdrom, die funktionelle gastrointestinale Störung mit der größten klinischen Bedeutung, ist mit einer intestinalen Hyperalgesie, Hypersensitivität und Hypervigilanz assoziiert. Dies hängt unmittelbar mit der zentralnervösen Reizverarbeitung zusammen: Bei Reizdarmpatienten werden bei intestinalen Schmerzreizen vermehrt Kerngebiete aktiviert, die mit der Schmerzwahrnehmung und der Stressverarbeitung zusammenhängen. Es lässt sich auch zeigen, dass an der viszeralen Hyperalgesie die Hypothalamus-Hypophysen-Nebennierenrinden (HPA)-Achse und insbesondere die Corticotropin-Releasing-Factor-1 (CRF1)-Rezeptoren beteiligt sind. Entgegen früheren Annahmen sind auch immunologische Prozesse beim Reizdarmsyndrom involviert, und auch diese sind von psychologischen Faktoren abhängig. Stress nimmt über verschiedene Wege Einfluss auf die immunologische Reaktion. Diese Entzündungsvorgänge entstehen dabei in Auseinandersetzung mit der bakteriellen Besiedelung des Darms, insbesondere des Colons. Stress nimmt Einfluss auf die qualitative und quantitative Zusammensetzung unseres «Mikrobioms», und die Zusammensetzung des Mikrobioms moderiert wiederum die Stressantwort. Offensichtlich erfordert ein vollständiges Verständnis funktioneller gastorintestinaler Beschwerden auch die Einbeziehung des Mikrobioms und der damit verbundenen immunologischen Vorgänge.

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Does Stress Influence Inflammatory Bowel Disease? The Clinical Data

Cited by 30 publications

References 53 publications

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

Transitioning patients with inflammatory bowel disease (IBD) from adolescent to adult services: a systematic review

Grundkonzepte der gastrointestinalen Psychophysiologie

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