Heitkemper M, Jarrett M, Taylor P, Walker E, Landenburger K, Bond E F
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 98195-7266, USA.
Nurs Res. 2001 Jan-Feb;50(1):15-23. doi: 10.1097/00006199-200101000-00004.
Irritable Bowel Syndrome (IBS) is a common chronic functional bowel disorder characterized by alterations in bowel patterns and abdominal pain. One factor that is conjectured to contribute to the onset of IBS is sexual and/or physical abuse in childhood or as an adult. This conjecture is supported by the increased prevalence of abuse experiences in persons with IBS when compared to healthy controls or those with organically-defined gastrointestinal (GI) disorders.
The purposes of the present study were to (a) compare the history of sexual and physical abuse in a sample of women with IBS to a sample of women without IBS and (b) to compare women with IBS who had sexual and physical abusive experiences to those who had not on GI symptoms, psychological distress, healthcare-seeking behavior, and physiological measures.
Data were collected from two samples of women (ages 18-40 years) with IBS and controls were recruited through community advertisements and letters from a health maintenance organization. Participants completed questionnaires (i.e., Sexual and Physical Abuse, Bowel Disease Questionnaire, Symptom Checklist-90-R) during an in-person interview and completed a symptom diary each night across one menstrual cycle. Cortisol and catecholamine levels were determined in morning urine samples on 6 days across the menstrual cycle.
More women in the IBS group reported unwanted sexual contact during childhood relative to control women. Within the IBS group, minimal differences were found between those who had experienced abuse and those who had not. Women with IBS who had experienced abuse reported greater impact of GI symptoms on activity.
The prevalence of a history of childhood sexual abuse experiences is elevated among women with IBS. However, within women with IBS, those with a history of abuse do not appear to be different from those with no history of abuse on GI symptoms, psychological symptoms, or physiological arousal indicators.
肠易激综合征（IBS）是一种常见的慢性功能性肠病，其特征为排便习惯改变和腹痛。一个被推测与IBS发病有关的因素是童年期或成年后遭受的性虐待和/或身体虐待。与健康对照者或患有器质性胃肠（GI）疾病的人相比，IBS患者中虐待经历的患病率增加，这支持了这一推测。
本研究的目的是（a）将IBS女性样本中的性虐待和身体虐待史与无IBS的女性样本进行比较，以及（b）将有性虐待和身体虐待经历的IBS女性与没有此类经历的IBS女性在胃肠道症状、心理困扰、就医行为和生理指标方面进行比较。
从两个年龄在18 - 40岁的IBS女性样本中收集数据，对照者通过社区广告和健康维护组织的信件招募。参与者在面对面访谈期间完成问卷（即性虐待和身体虐待问卷、肠道疾病问卷、症状自评量表90 - R），并在一个月经周期内每晚完成症状日记。在月经周期的6天内，测定晨尿样本中的皮质醇和儿茶酚胺水平。
与对照女性相比，IBS组中更多女性报告童年期有 unwanted sexual contact（此处unwanted sexual contact不太明确准确意思，字面为不必要的性接触）。在IBS组中，有虐待经历者和无虐待经历者之间差异极小。有虐待经历的IBS女性报告胃肠道症状对活动的影响更大。
IBS女性中童年期性虐待经历史的患病率升高。然而，在IBS女性中，有虐待史者在胃肠道症状、心理症状或生理唤醒指标方面与无虐待史者似乎没有差异。
