Low En X S, Mandhari Maimouna N K Al, Herndon Charles C, Loo Evelyn X L, Tham Elizabeth H, Siah Kewin T H
Department of Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.
Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.
J Neurogastroenterol Motil. 2020 Sep 30;26(4):437-446. doi: 10.5056/jnm20109.
BACKGROUND/AIMS: Adverse early life experiences are associated with the development of stroke, cancer, diabetes, and chronic respiratory and ischemic heart diseases. These negative experiences may also play a role in the development of irritable bowel syndrome (IBS)--a functional gastrointestinal disease. This review discusses the research to date on the parental, perinatal, and childhood risk and protective factors associated with the development of IBS.
A literature search was completed for studies published between 1966 and 2018 that investigated premorbid factors occurring during the perinatal and childhood periods as well as parental factors that were associated with the development of IBS.
Twenty-seven studies fulfilled the review criteria. Risk factors that appeared in more than one study included: (1) parental IBS, substance abuse, parental punishment, and rejection as parental risk factors; (2) low birth weight as a perinatal risk factor; and (3) crowded living conditions in low-income families, childhood anxiety, depression, or child abuse as childhood risk factors. Protective factors for IBS were emotional warmth from the parents and being born to an older mother.
More effort is needed to identify what fetal and maternal factors are associated with low birth weight and IBS. A well-executed prospective birth cohort with a collection of bio-samples and functional data will provide a better understanding of how adversity and the interplay between genetics, epigenetics, and numerous risk factors affect the development of IBS.
背景/目的:早期不良生活经历与中风、癌症、糖尿病以及慢性呼吸道疾病和缺血性心脏病的发生有关。这些负面经历也可能在肠易激综合征(IBS)——一种功能性胃肠疾病的发生中起作用。本综述讨论了迄今为止关于与IBS发生相关的父母、围产期和儿童期风险及保护因素的研究。
完成了一项文献检索,检索1966年至2018年发表的研究,这些研究调查了围产期和儿童期出现的病前因素以及与IBS发生相关的父母因素。
27项研究符合综述标准。在不止一项研究中出现的风险因素包括:(1)父母患IBS、药物滥用、父母惩罚和拒绝作为父母风险因素;(2)低出生体重作为围产期风险因素;(3)低收入家庭拥挤的生活条件、儿童焦虑、抑郁或虐待儿童作为儿童期风险因素。IBS的保护因素是来自父母的情感温暖和母亲年龄较大。
需要更多努力来确定哪些胎儿和母亲因素与低出生体重和IBS有关。一个精心实施的前瞻性出生队列,收集生物样本和功能数据,将有助于更好地理解逆境以及基因、表观遗传和众多风险因素之间的相互作用如何影响IBS的发生。