A greater number of early adverse life events (EALs), as well as more significant severity of traumatic events have been found to be associated with increased risk of developing irritable bowel syndrome (IBS), according to a study published in the Journal of Clinical Gastroenterology.

Researchers recruited patients with a confirmed diagnosis of IBS (n=197) as well as healthy control subjects (n=165) aged ≥18 years of age to determine whether patients with IBS report a greater number of EALs compared with healthy control subjects, whether trauma severity and first age of EAL increased the risk of developing IBS, whether confiding in others reduced the odds of IBS; whether the number, trauma severity, and first age of EAL are associated with IBS symptom severity; and if differences exist in men vs women with IBS.

Patients with IBS as confirmed using the Rome III diagnostic criteria completed the Bowel Symptom Questionnaire (BSQ). The BSQ measures overall IBS symptom severity (ranging from 0 [not at all severe] to 20 [most intense]), usual severity of IBS symptoms (1 [no symptoms] to 5 [very severe]), and abdominal pain severity (0 [no pain] to 20 [most intense pain imaginable]). Patients also completed the Childhood Traumatic Events Scale (CTES), a 6-item measure of traumatic events that may have occurred before the age of 17 years. The questionnaire asks age at the time of the traumatic event, trauma severity (1 [not at all traumatic] to 7 [extremely traumatic]), and how much the patient confided in others during that time (1[not at all] to 7 [a great deal]). Other psychometric measures used for the study included the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale, the Personal Health Questionnaire, and the Visceral Sensitivity Index.

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Compared with the healthy control group, the IBS group was composed of more women, had higher scores for HADS anxiety and depression symptoms, and reported greater nongastrointestinal symptom severity. After adjusting for sex and body mass index, patients with IBS reported a greater number of EALs compared with healthy control subjects; 2 or more traumatic events were reported by approximately 45% of patients with IBS compared with 27% of healthy control subjects (odds ratio [OR], 1.36). Patients who experienced sexual trauma (P =.002), were victims of violence (P =.006), or had other major upheaval (P <.001) were found to be at increased risk of developing IBS. Age at time of experiencing an EAL was not predictive of having IBS (P =.33) and did not correlate with the age of onset of symptoms (P =.37).

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A greater total trauma severity score increased the odds of having IBS (OR, 1.13); in contrast, confiding in others about the traumatic event at the time of occurrence decreased the odds of having IBS (OR, 0.83). Trauma severity and confiding in others were not associated with nongastrointestinal symptom severity, including current symptoms of anxiety and depression, stress, somatic symptom severity, and gastrointestinal symptom anxiety. No differences were found in men vs women with IBS (P= .74-.95) or healthy control subjects (P=.17-.78) in the prevalence or type of EALs, trauma severity, and confiding in others, as well as when comparing individual items on the CTES (P= .15-.99).

“This study found that a greater number of EALs was associated with an increased odds of having IBS, consistent with our previous studies using other EAL questionnaires, including the Adverse Childhood Experiences and Early Trauma Inventory Self Report,” the authors concluded.


Ju T, Naliboff BD, Shih W, et al. Risk and protective factors related to early adverse life events in irritable bowel syndrome [published online December 19, 2018]. J Clin Gastroenterol. doi: 10.1097/MCG.0000000000001153