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02-05-2010 | Gastroenterology | Article

Psychological factors common trigger for IBD


Free abstract

MedWire News: Perceived stress, negative mood, and major life events are significantly associated with inflammatory bowel disease (IBD) flares, show study results.

Notably, the researchers found no evidence for an association between IBD flares and nonsteroidal anti-inflammatory drug (NSAID) or antibiotic use, or non-enteric infection rates, however.

Charles Bernstein (University of Manitoba, Winnipeg, Canada) and colleagues recruited 704 patients with IBD (278 ulcerative colitis; 426 Crohn’s disease) who were aged 52.1 years on average to take part in their study.

The participants were surveyed every 3 months for 1 year to assess disease activity, medication use, infections, stress, major life events, and positive and negative affect. In total, 552 participants completed all five questionnaires.

In total, 174 patients who reported flares were compared with 209 patients who did not report flares.

Writing in the American Journal of Gastroenterology, the researchers report that any major life stress event, high perceived stress, and high negative mood significantly increased risk for flares 1.69-, 2.63-, and 1.73-fold, respectively.

However, other factors such as use of NSAIDs, infection, and use of antibiotics, did not significantly increase the risk for flares in these individuals.

Results from multivariate analysis indicated that only high-perceived stress significantly increased the risk for flares 2.40-fold.

“This study adds to the growing evidence that psychological factors contribute to IBD symptom flares,” say Bernstein et al.

“Stress occurs commonly in everyday life. As the effects can be deleterious for IBD, serious consideration should be given to stress management approaches for appropriate patients,” they conclude.

“From a preventive perspective, providing stress management training at the point of diagnosis, or from a high-risk perspective, fast tracking patients who report high and enduring stress levels for timely stress interventions may be as important an adjunct to IBD therapy as the medication regimens that are currently used to treat the active symptoms.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert