This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Elsenbruch, S. Articles by Orr, W. C. Search for Related Content PubMed PubMed Citation Articles by Elsenbruch, S. Articles by Orr, W. C. Related Collections Gastrointestinal Psychophysiology Sexual Medicine: Female

Psychological and Physiological Responses to Postprandial Mental Stress in Women With the Irritable Bowel Syndrome

¹Current affiliation: Institute for Medical Psychology, University Clinic of Essen, Germany.
Lynn Institute for Healthcare Research (S.E. and W.C.O.) and VA Medical Center (W.R.L.), Oklahoma City, OK.

Address correspondence to: William C. Orr, PhD, Lynn Institute for Healthcare Research, 5300 N. Independence, Suite 130, Oklahoma City, OK 73112. Email: okorr{at}theshop.net

OBJECTIVE: To investigate the psychological (affective and symptomatic) and physiological (autonomic and cortisol) responses to postprandial mental stress in women with irritable bowel syndrome (IBS). It was hypothesized that patients with IBS would show exaggerated autonomic and cortisol responses to the psychological stressor and that the stressor would enhance gastrointestinal symptoms.

METHOD: Twenty-four women with IBS and 20 healthy women participated in the two-day study protocol. Both days were identical, with the exception that on one day, a stressful mental task was completed after ingestion of a standard meal. Heart rate variability, cortisol, affective, and symptomatic responses were measured before and after application of the stressor.

RESULTS: Patients with IBS demonstrated increased negative affect at baseline and in response to the stressor. Gastrointestinal symptoms were not affected by the stressor. Appraisal of the stressor by patients with IBS was not different from that of controls. There were no group differences in the autonomic response to the stressor. There was no overall cortisol response to the stressor in either group.

CONCLUSIONS: Patients with IBS respond with greater negative affect to postprandial psychological stress as well as to food intake alone, and they can be distinguished from controls on the basis of self-report data. Patients with IBS cannot be differentiated from controls on the basis of the pattern of changes in sympathetic activation after the mental stressor. The stressor used in this study did not elicit a cortisol response in either group.

Key Words: Irritable bowel syndrome • autonomic nervous system • cortisol • mental stress • heart rate variability • functional bowel disorder

Abbreviations: IBS = irritable bowel syndrome; HRV = heart rate variability; LF = low frequency; HF = high frequency; GI = gastrointestinal; ANS = autonomic nervous system; CNS = central nervous system; ECG = electrocardiogram; SEM = standard error of the mean; BDI = Beck Depression Inventory; HPA = hypothalamic pituitary adrenal

This article has been cited by other articles:

				T. Ritz and B. Dahme Implementation and Interpretation of Respiratory Sinus Arrhythmia Measures in Psychosomatic Medicine: Practice Against Better Evidence? Psychosom Med, July 1, 2006; 68(4): 617 - 627. [Abstract] [Full Text] [PDF]

				K Tillisch, E A Mayer, J S Labus, J Stains, L Chang, and B D Naliboff Sex specific alterations in autonomic function among patients with irritable bowel syndrome Gut, October 1, 2005; 54(10): 1396 - 1401. [Abstract] [Full Text] [PDF]

				P. P. J. van der Veek, C. A. Swenne, H. v. d. Vooren, A. L. Schoneveld, R. Maestri, and A. A. M. Masclee Viscerosensory-cardiovascular reflexes: altered baroreflex sensitivity in irritable bowel syndrome Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2005; 289(4): R970 - R976. [Abstract] [Full Text] [PDF]