Perceived Stress in Patients with Common Gastrointestinal Disorders: Associations with Quality of Life, Symptoms and Disease Management

Abstract

Objective and Methods: Given associations between stress, and gastrointestinal (GI) symptoms and disorders, this pilot study assesses relationships between perceived stress, quality of life (QOL) and self-reported pain ratings as an indicator of symptom management in patients who self-reported gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Results: In a sample of GI patients (n=402), perceived stress positively correlated with depression (r=0.76, p<0.0001), fatigue (r=0.38, p< 0.0001), sleep disturbance (r=0.40, p<0.0001), average pain (r=0.26, p<0.0001) and worst pain (r=0.25, p< 0.0001). Higher perceived stress also correlated with lower mental health-related QOL. Assessed in subgroups, similar correlations were found for the participants with GERD (n=188), IBS (n=132) and IBD (n=82). Finally, there were significant correlations within both the GERD and IBD cohorts between perceived stress, and average pain (r=0.34, p<0.0001; r=0.32, p<0.0001respectively) and worst pain (r=0.29, p<0.0001; r=0.35, p<0.01respectively). Conclusions: Perceived stress broadly correlated with QOL characteristics in patients with GERD, IBS, and IBD, and their overall QOL was significantly lower than that of the general population. Perceived stress also appeared to be an indicator of symptom management (self-reported pain ratings) in GERD and IBD, but not IBS. Future research is needed using objective measures of stress and symptom/disease management to confirm these associations, and to prospectively evaluate the ability of stress reduction interventions to improve perceived stress, QOL and disease management in these GI disorders; integrative medicine treatment programs that simultaneously target such multiple symptoms may be particularly beneficial to study.

Predictors of Health-related Quality of Life in Irritable Bowel Syndrome Patients Compared With Healthy Individuals

“…Perceived stress has been shown to independently correlate with the presence of IBS, 39 self-rated health, 11 and HRQOL in IBS. 40 Because IBS is a stress-sensitive disorder, 41 we expected PSS, which serves as an appraisal of current stress, to have a robust impact on HRQOL. Stress is known to be associated with the onset and symptom flares of IBS.…”

Prevalence and risk factors of gastro-esophageal reflux disease among undergraduate medical students from a southern Indian medical school: a cross-sectional study

“…Importantly, psychological factors are linked to the illness experience and can modify subjective symptoms [ 10 ]. It is observed that the quality of life in those with GERD symptoms is lower when compared to the general population [ 11 ]. A unique combination of psychological factors and lifestyle changes occur when students enter undergraduate training in various disciplines.…”

Alexithymia and Inflammatory Bowel Disease: A Systematic Review

“…The excluded publications did not fulfill the inclusion criteria as two were systematic reviews, three were conference/meeting abstracts, and one was out of scope. Thus, the remaining 10 publications were full text reviewed, and five of them were removed for the following reasons: two did not provide English full text as they were written in Portuguese (Amorim and Guerra, 2018 ) and Russian (Mnatsakanyan et al, 2016 ), one did not provide empirical data about alexithymia (Edman et al, 2017 ), and two were not specifically addressed to patients with IBD (Cozzolongo et al, 2015 ; Schauer et al, 2019 ). We concluded that five papers could be included in our systemic review based on the inclusion criteria.…”