Polish scientists have found a significant connection between adverse childhood experiences (ACEs) and the severity of irritable bowel syndrome (IBS), particularly in patients who also struggle with alexithymia—the inability to recognize or describe their emotions.
IBS is a chronic digestive disorder characterized by symptoms such as abdominal pain, bloating, diarrhea, constipation, and irregular stool consistency. Though the symptoms are often severe, they are not linked to any identifiable pathology in the digestive system, which makes IBS a psychosomatic condition. The disorder affects an estimated 5-20% of the population, with women being more frequently impacted than men.
A study published in Journal of Psychosomatic Research underscores the influence of ACEs on the course of IBS. ACEs refer to traumatic experiences during childhood, such as physical or emotional abuse, neglect, family addiction, or extreme poverty. According to the survey, 53% of respondents in Poland reported having experienced ACEs.
Professor Marcin Rzeszutek, head of the Trauma Research Laboratory at the University of Warsaw’s Faculty of Psychology, noted that many IBS patients have a history of childhood trauma, which can have lasting effects on their condition.
He said: ’Our results indicate the need for an individual approach to the treatment of IBS, taking into account mental health. Many patients with IBS have experienced childhood traumas, which in turn is important information about the possible course of the disease and the effectiveness of therapy. Therefore, it is worth introducing screening questionnaires regarding traumatic childhood experiences as part of the diagnosis and treatment. This makes it easier to better adjust treatment, for example by combining medications, dietary consultations and psychological support.’
A real-world example comes from Małgorzata Desmond, PhD, a dietitian from University College London, who worked with a young patient suffering from severe digestive issues. After ruling out physiological causes, Desmond investigated the patient's early childhood history and uncovered severe trauma, including abuse by the father, which had led to eating disorders and disrupted the gut microbiome, ultimately worsening IBS symptoms. The patient’s recovery was facilitated through joint treatment involving both a psychologist and a dietitian.
A real-world example comes from Małgorzata Desmond, PhD, a dietitian from University College London, who worked with a young patient suffering from severe digestive issues. After ruling out physiological causes, Desmond investigated the patient's early childhood history and uncovered severe trauma, including abuse by the father, which had led to eating disorders and disrupted the gut microbiome, ultimately worsening IBS symptoms. The patient’s recovery was facilitated through joint treatment involving both a psychologist and a dietitian.
The researchers suggest that early traumatic experiences can influence IBS through two primary neurobiological pathways: Dysregulation of the HPA Axis: Trauma can disturb the hypothalamic-pituitary-adrenal (HPA) axis, leading to altered gut motility and microbiome imbalances.
And Disorders in the Brain-Gut Axis: Traumatic experiences may impair the brain-gut communication, which can result in hypersensitivity to gut sensations and a lowered pain threshold, intensifying IBS symptoms.
The study also examined the role of alexithymia, a condition often associated with ACEs, in exacerbating IBS. Alexithymia, which affects about 10% of the population, is characterized by difficulty identifying and describing one's emotions. This inability to process emotional experiences may contribute to the somatization of distress, where physical symptoms, such as gut pain, are interpreted as emotional or psychological distress.
Among a sample of 245 IBS patients observed over nearly two months, those with higher levels of alexithymia, particularly those with a history of ACEs, reported significantly worse IBS symptoms. The study found that individuals who were unable to recognize or name their emotions were more likely to experience severe IBS symptoms, as well as anxiety and depression.
The findings emphasize the importance of a holistic approach to IBS treatment, where psychological factors, including past traumas and emotional regulation, are considered alongside gastrointestinal symptoms. Professor Rzeszutek advocates for comprehensive diagnostic strategies that take into account the psychological background of patients, rather than focusing solely on physical symptoms. This, he believes, could lead to more effective and personalized treatment plans.
The researchers also highlight the need for future studies to explore how treating underlying emotional and psychological issues could improve IBS outcomes.
'Diagnostics and treatment of IBS requires comprehensive treatment strategies focused on many co-occurring symptoms, instead of focusing solely on symptoms related to the gastrointestinal tract. We believe that the results of this study have important clinical implications’, Rzeszutek said. (PAP)
Nauka w Polsce, Ludwika Tomala
Nauka w Polsce, Ludwika Tomala
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