Sexual and physical abuse and gastrointestinal illness

Drossman, D. A.; Talley, NJ; Leserman, Jane; Olden, Kevin W.; Barreiro, Marcelo A.

doi:10.1097/00042737-199601000-00025

Cited by 29 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[20][21][22][23] In light of these relationships, some experts have recommended that physicians ask about physical or sexual abuse when a patient complains of unexplained gastrointestinal symptoms. 24,25 Despite a growing awareness of the relationship between child abuse and neglect and gastrointestinal symptoms later in life, only 1 study has focused on the impact of abuse on gastrointestinal symptoms in children. A chart review study found that 26.4% of children who were medically evaluated after sexual abuse complained of unexplained abdominal pain in the 1 to 2 years after their visit compared with only 6.9% of children who were not abused.…”

Section: G a S T Roin T Es T Ina L Sy Mp To Ms A Nd Chil D M A Lt R Ementioning

confidence: 99%

Unexplained Gastrointestinal Symptoms After Abuse in a Prospective Study of Children at Risk for Abuse and Neglect

Tilburg¹,

Runyan²,

Zolotor³

et al. 2010

The Annals of Family Medicine

View full text Add to dashboard Cite

PURPOSE Unexplained gastrointestinal symptoms are more common in adults who recall abuse as a child; however, data available on children are limited. The aim of this study was to investigate the association of childhood maltreatment and early development of gastrointestinal symptoms and whether this relation was mediated by psychological distress.METHODS Data were obtained from the Longitudinal Studies of Child Abuse and Neglect, a consortium of 5 prospective studies of child maltreatment. The 845 children who were observed from the age of 4 through 12 years were the subjects of this study. Every 2 years information on gastrointestinal symptoms was obtained from parents, and maltreatment allegations were obtained from Child Protective Services (CPS). At the age of 12 years children reported gastrointestinal symptoms, life-time maltreatment, and psychological distress. Data were analyzed by logistic regression.RESULTS Lifetime CPS allegations of sexual abuse were associated with abdominal pain at age 12 years (odds ratio [OR] = 1.75; 95% confi dence interval [CI] = 1.1-2.47). Sexual abuse preceded or coincided with abdominal pain in 91% of cases. Youth recall of ever having been psychologically, physically, or sexually abused was signifi cantly associated with both abdominal pain and nausea/vomiting (range, OR = 1.5 [95% CI, 1.1-2.0] to 2.1 [95% CI, 1.5-2.9]). When adjusting for psychological distress, most effects became insignifi cant except for the relation between physical abuse and nausea/vomiting (OR = 1.5; 95% CI, 1.1-2.2).CONCLUSION Youth who have been maltreated are at increased risk for unexplained gastrointestinal symptoms, and this relation is partially mediated by psychological distress. These fi ndings are relevant to the clinical care for children who complain of unexplained gastrointestinal symptoms.

show abstract

Section: G a S T Roin T Es T Ina L Sy Mp To Ms A Nd Chil D M A Lt R Ementioning

confidence: 99%

Unexplained Gastrointestinal Symptoms After Abuse in a Prospective Study of Children at Risk for Abuse and Neglect

Tilburg¹,

Runyan²,

Zolotor³

et al. 2010

The Annals of Family Medicine

View full text Add to dashboard Cite

show abstract

“…IBS is most commonly associated with anxiety disorders, depression, dysthymia [25], and to a lesser extent, schizophrenia [26]. High rates of early childhood adversity (child sexual or physical abuse) have been found among individuals diagnosed with IBS [27,28]; this is linked to a high rate of seeking health care [29]. Individuals with IBS also have high levels of psychologic distress (anxiety or depressive symptoms) that are of sufficient severity to reach a categoric psychiatric diagnosis [3,6,30,31], but do not contribute to health-care seeking, as do the high levels of personality dysfunction found among IBS patients [6,32].…”

Section: Opinion Statementmentioning

confidence: 99%

Psychologic therapies for irritable bowel syndrome

Boyce

2001

Curr Treat Options Gastro

View full text Add to dashboard Cite

The treatment of patients with irritable bowel syndrome (IBS) is a difficult task, as the results from therapy with pharmacologic agents have been disappointing. Psychologic treatments, in particular cognitive behavior therapy, hypnotherapy, and dynamic psychotherapy have all shown to be effective in the treatment of patients with IBS. Underpinning all these treatments is a clear understanding of a biopsychosocial model of interaction between emotion and gut function in IBS. These psychologic therapies are intended to break the negative feedback loop between emotion and gut function in order to reduce symptoms. Attention to the psychologic issues underlying IBS helps reduce psychosocial factors that maintain the presence of symptoms and inappropriate health-care seeking behavior. There are a number of common elements in the psychologic approaches that can be used in routine clinical practice; these include a detailed assessment, psychoeducation, support, and reassurance.

show abstract

“…However, paradoxically, only 16.6% of the Residents mentioned these factors as constituting significant enough suffering to warrant referral for psychotherapy. Patients with functional gastrointestinal disorders are more likely to report a history of sexual abuse compared to those with gastrointestinal disorders of organic etiology (Drossman et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

“…Psychological distress may lead, for example, to increased bowel motility and abdominal discomfort through the central, autonomic and enteric nervous systems (Drossman, Talley, Leserman, Olden & Barreiro, 1995;Leroi et al, 1995).…”

mentioning

confidence: 99%