The Relationship Between PTSD and IBS (Irritable Bowel Syndrome)

Here's Why PTSD and IBS Often Occur Together

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At first glance, posttraumatic stress disorder (PTSD) and irritable bowel syndrome (IBS) may not seem to have any special connection. But they do. In fact, PTSD and IBS often occur together. If you have PTSD, IBS, or both, understanding how they're connected can help you seek out the most appropriate treatment.

Let's start with IBS.

What Should You Know About IBS?

IBS is a digestive disorder that's more common than you may think:

  • Between 12% and 20% of Americans have IBS.
  • IBS is more common among women.

People with IBS have chronic abdominal pain and major problems with bowel function such as urgent diarrhea, chronic constipation, or, at different times, both. IBS appears to stem from a malfunction in how the intestines work; however, this malfunction is not well understood or easily detected.

The causes of IBS are not completely understood, either, but there is evidence connecting IBS with certain mental health problems. For example, compared to people without IBS, people with IBS are more likely to have mood and anxiety disorders. The mental health problems occur first, then the IBS, suggesting that having any of these problems may increase a person's risk of developing IBS.

PTSD and IBS

If you have PTSD, you'll be interested to learn that anxiety disorders, particularly PTSD, are the mental health problems most likely to occur before IBS.

In fact, there's a strong link between stress and IBS.

What's the connection between PTSD and IBS? People who have IBS also seem to have higher rates of exposure to traumatic events. For example, in one study, 86% of IBS patients reported past traumatic events, most commonly the unexpected death of a relative or close friend.

In fact, people with IBS generally have higher rates of PTSD than people without IBS. For example, a group of researchers from the Medical University of South Carolina found that a little over one-third of the IBS patients involved in their study had a diagnosis of PTSD. Another study, of women veterans with and without IBS, at the Baylor College of Medicine in Houston, Texas, found that 22% of the women with IBS had PTSD compared to only 11% of the women who didn't.

Why Do Traumatic Events and PTSD Lead to IBS?

The answer to this question isn't yet clear. But it's likely that chronic stress from a traumatic event or PTSD can harm a person's digestive system.

In PTSD, your body's "fight or flight" response is frequently activated, releasing a substance in the brain called corticotropin-releasing factor (CRF). Among other things, CRF increases mucus and water secretion in your colon and disrupts colon motility (speed of muscle contraction). It's likely, then, that high levels of CRF contribute to the development of IBS in people with PTSD.

The Benefits of Treating PTSD and IBS

If you have PTSD and IBS, the stress of having PTSD can make your IBS symptoms worse--and vice versa. Fortunately, treating your PTSD may also improve your IBS. One of the most effective treatments for PTSD is exposure therapy, and other options are available. If you're looking for a PTSD treatment provider, a number of websites can help you connect with providers in your area.

If you're interested in exploring different treatment options for your IBS, you can learn more about IBS and its treatment from the About.com IBS website.

Sources:

Cohen, H., Jotkowitz, A., Buskila, D., Pelles-Avraham, S., Kaplan, Z., Neumann, L., & Sperber, A.D. (2006). Posttraumatic stress disorder and other comorbidities in a sample population of patients with irritable bowel syndrome. European Journal of Internal Medicine, 17, 567-571.

Irwin, C., Falsetti, S.A., Lydiard, R.B., Ballenger, J.C., Brock, C.D., & Brener, W. (1996). Comorbidity of posttraumatic stress disorder and irritable bowel syndrome. Journal of Clinical Psychiatry, 57, 576-578.

Lydiard, R.B., & Falsetti, S.A. (1999). Experience with anxiety and depression treatment studies: Implications for designing irritable bowel syndrome clinical trials. American Journal of Medicine, 107, 65S-73S.

Sykes, M.A., Blanchard, E.B., Lackner, J., Keefer, L., & Krasner, S. (2003). Psychopathology in irritable bowel syndrome: Support for a psychophysiological model. Journal of Behavioral Medicine, 26, 361-372.

Weaver, T.L., Nishith, P., & Resick, P.A. (1998). Prolonged Exposure Therapy and irritable bowel syndrome: A case study examining the impact of a trauma-focused treatment on a physical condition. Cognitive Behavioral Practice, 5, 103-122.

White, D.L., Savas, L.S., Daci, K., Elserag, R., Graham, D.P., Fitzgerald, S.J., Smith, S.L, Tan, G., & El-Serag, H.B (2010). Trauma history and risk of the irritable bowel syndrome in women veterans. Alimentary Pharmacology and Therapeutics, 32, 551-561.

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