Altered Psychobiological Responsiveness in Women With Irritable Bowel Syndrome

Bibliographic Data

ID19306528
AuthorsKerstin A Suárez-Hitz, Kerstin Suarez-Hitz (University of Zurich), Bärbel Otto (0000-0002-7665-9421), Martin Bidlingmaier (0000-0002-4681-6668), Werner Schwizer, Michael Fried (0000-0001-6883-8174), Ulrike Ehlert (0000-0002-1982-8321, corresponding author)
Year2012
Volume74
Issue2
Pages221-231
Publication date2012-02-01
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0b013e318244fb82
PMID22286854
OpenAlexW1974203392
LanguageEN
Citations received2
References cited66

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

Adrenocorticotropic hormone · Basal (medicine) · Circadian rhythm · Cortisol awakening response · Fight-or-flight response · Hormone · Hydrocortisone · Hypothalamic–pituitary–adrenal axis · Irritable bowel syndrome · Morning · Psychiatry · Stressor · Trier social stress test · Endocrinology · Gastrointestinal motility and disorders · Internal Medicine · Medicine · Microscopic Colitis · Psychology · Stress Responses and Cortisol

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