IBS Abdominal Pain Mediated by Somatization in Adults With Childhood Trauma

Somatization plays a partial role in mediating the relationship between childhood trauma and irritable bowel syndrome (IBS) symptoms of abdominal pain and bloating in adulthood, according to study findings published in the Journal of Clinical Gastroenterology.

Research has suggested that early life experiences, such as child abuse, can influence the body’s response to stress and illness, which could potentially lead to issues with gut motility. Researchers conducted a study to better understand the relationship between childhood trauma and the development of gastrointestinal (GI) symptoms among adults with IBS. 

A total of 436 participants with IBS were enrolled from 2 tertiary academic medical centers. The average age of study participants was 41.6 years, and a majority of the population were women (79%). 

Participants were required to report IBS symptoms of at least moderate intensity. Some exclusion criteria were comorbid organic GI illnesses, intellectual development disorders, history of schizophrenia or other psychotic disorders, and current depression or suicidal ideation. 

The Rome III diagnostic criteria were used to diagnose IBS. Childhood trauma was evaluated through 2 questions from the Illinois Women’s Health Registry, with a score of 0 indicating no abuse and a score of 2 indicating both physical and sexual abuse. The researchers used the IBS Symptom Severity Scale to measure symptom severity. 

Participants were randomly assigned to receive one of the following treatments:

• standard cognitive behavioral therapy (CBT) (10 weekly sessions);
• minimal-contact CBT (4 home-based sessions);
• 4 sessions of IBS education

Of all the participants, 27.3% reported any physical or sexual abuse in childhood; specifically, 24.5% reported physical abuse, 8.2% reported sexual abuse, and 5.4% reported both types of abuse. There were no significant differences between genders in experiencing all types of childhood abuse, with 27.2% of women and 29% of men reporting any type of abuse in childhood (P =.724).

Patients who experienced childhood abuse reported less satisfaction with their bowel habits (P =.004) compared with those who did not report abuse. Regarding mental health, patients reporting any abuse had higher levels of depression (P =.011), anxiety (P <.001), and somatization (P <.001) compared with those without a history of abuse. 

The bootstrapping analysis revealed that childhood trauma was related to somatization (P =.0011), anxiety (P <.001) and depression scores (P =.013). Somatization was related to abdominal pain (P <.001) and abdominal bloating (P =.009), but not related to satisfaction with bowel habits (P =.159).

Study limitations include recall bias, the inability to determine a causal relationship, and the potential for somatization to affect severity ratings.

“It is possible that there are neurobiological mechanisms and coping strategies that change in response to past trauma, thereby ultimately affecting an individual’s predisposition to somaticize, though causation cannot be proven with this study,” study authors wrote.

This article originally appeared on Gastroenterology Advisor