Abstract
Little is known about the prevalence and risk factors for development of irritable bowel syndrome (IBS) in Japan. In the United States, it is reported that heredity and social learning contribute to the development of IBS. Our aims were (1) to estimate the prevalence of IBS, (2) to confirm that subjects with IBS are more likely to have parents with a history of bowel problems, (3) to confirm that gastroenteritis is a risk factor for IBS, and (4) to determine whether these two risk factors interact with psychological distress. Prevalence was estimated from a sample of 417 young adults seen for annual health screening examinations. To evaluate risk factors related to consulting physicians, the 46 subjects who fulfilled Rome II diagnostic criteria for IBS but denied ever having seen a physician about these symptoms (IBS non-consulters) were compared to the 317 subjects who did not meet the criteria for IBS (controls) and to a group of 56 patients diagnosed with IBS by gastroenterologists (IBS patients). All subjects completed the Gastrointestinal Symptoms Rating Scale, the State-Trait Anxiety Inventory, the Self-Rating Depression Scale, the Perceived Stress Scale, and the SF-36 quality of life scale. Fourteen and two-tenths percent (15.5% of females and 12.9% of males) of the community sample met the criteria for IBS diagnosis, of whom 22% consulted physicians. IBS patients and IBS nonconsulters were more likely than controls to have a parental history (33.9 vs. 12.6%, P < 0:001, for patients and 26.1 vs. 12.6%, P < 0:01, for nonconsulters) and were more likely to report an infective history compared to controls (44.6 vs. 16.1%, P < 0:001, for patients and 32.6 vs. 16.1%, P < 0:01, for nonconsulters). Two-way analysis of variance showed that the parental history was associated with a significantly greater impact on symptoms of indigestion, diarrhea, constipation, state and trait anxiety, and the SF-36 scales for social functioning and role emotional and that an infective history was associated with a greater impact on bodily pain. Both a parental history of bowel problems and a history of acute gastroenteritis are significant risk factors for development of IBS in Japan, as reported for the United States. Moreover, patients with such a family history show more psychological distress than other patients.
Similar content being viewed by others
REFERENCES
American Gastroenterological Association medical position statement: irritable bowel syndrome. Gastroenterology 112: 2118–2119, 1997
Saito YA, Schoenfeld P, Locke GR 3rd: The epidemiology of irritable bowel syndrome in North America: a systematic review. Am J Gastroenterol 97: 1910–1915, 2002
Chey WD, Olden K, Carter E, Boyle J, Drossman DA, Chang L: Utility of the Rome I and Rome II criteria for irritable bowel syndrome in U.S. women. Am J Gastroenterol 97: 2803–2811, 2002
Drossman DA, Li Z, Andruzzi E, Temple RD, Talley NJ, Thompson WG, Whitehead WE, Janssens J, Funch-Jensen P, Corazziari E, Richter JE, Koch GG: U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 38: 1569–1580, 1993
Talley NJ, Zinsmeister AR, Melton LJ 3rd: Irritable bowel syndrome in a community: symptom subgroups, risk factors, and health care utilization. Am J Epidemiol 142: 76–83, 1995
Osterberg E, Blomquist L, Krakau I, Weinryb RM, Asberg M, Hultcrantz R: A population study on irritable bowel syndrome and mental health. Scand J Gastroenterol 35: 264–268, 2000
Whitehead WE, Crowell MD. Psychologic considerations in the irritable bowel syndrome. Gastroenterol Clin North Am 20: 249–267, 1991
Drossman DA: Do psychosocial factors define symptom severity and patient status in irritable bowel syndrome? AmJ Med 107: 41S-50S, 1999
Whitehead WE, Burnett CK, Cook EW 3rd, Taub E: Impact of irritable bowel syndrome on quality of life. Dig Dis Sci 41: 2248–2253, 1996
Gralnek IM, Hays RD, Kilbourne A, Naliboff B, Mayer EA: The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology 119: 654–660, 2000
Levy RL, Jones KR, Whitehead WE, Feld SI, Talley NJ, Corey LA: Irritable bowel syndrome in twins: Heredity and social learning both contribute to etiology. Gastroenterology 121: 799–804, 2001
Morris-Yates A, Talley NJ, Boyce PM, Nandurkar S, Andrews G: Evidence of a genetic contribution to functional bowel disorder. Am J Gastroenterol 93: 1311–1317, 1998
Levy RL, Whitehead WE, Von Korff MR, Feld AD: Intergenerational transmission of gastrointestinal illness behavior. Am J Gas-troenterol 95: 451–456, 2000
Gwee KA, Leong YL, Graham C, McKendrick MW, Collins SM, Walters SJ, Underwood JE, Read NW: The role of psychological and biological factors in postinfective gut dysfunction. Gut 44: 400–406, 1999
Neal KR, Barker L, Spiller RC: Prognosis in post-infective irritable bowel syndrome: A six year follow up study. Gut 51: 410–413, 2002
Drossman DA, Talley NJ, Thompson WG, Corazziari E, Whitehead WE: Rome II: The Functional Gastrointestinal Disor-ders. McLean, VA, Degnon Associates, 2000
Svedlund J, Sjodin I, Dotevall G: GSRS-A clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci 33: 129–134, 1988
Hongo M, Fukuhara S, Green J, Wiklund I: Validation of the Japanese version of the gastrointestinal symptom rating scale (GSRS-J). Gastroenterology 116: A65, 1999
Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA: Manual for State-Trait Anxiety Inventory. Palo Alto, Consulting Psychologists Press, 1983
Shimizu H, Imae K: Development of the Japanese edition of the Spielberger Stait-Trait Anxiety Inventory (STAI) for student use. Jap J Educ Psychol 29: 348–353, 1981 (in Japanese)
Zung WWK: A self-rating depression scale. Arch Gen Psychiatry 12: 63–70, 1965
Fukuda K, Kobayashi S: A study on a self-rating depression scale. Psychiatr Neurol Japon 75: 673–679, 1973 (in Japanese)
Cohen S, Kamarck T, Mermelstein R: Aglobal measure of perceived stress. J Health Soc Behav 24: 385–396, 1983
Iwahashi S, Tanaka Y, Fukudo S, Hongo M: The development of the Japanese version of the Perceived Stress Scale. Jpn J Psychosom Med 42: 459–466, 2002 (in Japanese)
Ware JE, Sherbourne CD: The MOS 36-item short-form health sur-vey (SF-36). Med Care 22: 3–12, 1992
Fukuhara S, Ware JE Jr, Kosinski M, Wada S, Gandek B: Psycho-metric and crinical tests of validity of the Japanese SF-36 Health Survey. J Clin Epidemiol 51: 1045–1053, 1998
Badia X, Mearin F, Balboa A, Baro E, Caldwell E, Cucala M, Diaz-Rubio M, Fueyo A, Ponce J, Roset M, Talley NJ: Burden of illness in irritable bowel syndrome comparing Rome I and Rome II criteria. Pharmacoeconomics 20: 749–758, 2002
Thompson WG, Irvine EJ, Pare P, Ferrazzi S, Rance L: Functional gastrointestinal disorders in Canada: first population-based survey using Rome II criteria with suggestions for improving the question-naire. Dig Dis Sci 47: 225–235, 2002
Talley NJ, O'Keefe EA, Zinsmeister AR, Melton LJ 3rd: Preva-lence of gastrointestinal symptoms in the elderly: a population-based study. Gastroenterology 102: 895–901, 1992
Drossman DA, McKee DC, Sandler RS, Mitchell CM, Lowman BC, Burger AL, Cramer EM: Psychosocial factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome. Gastroenterology 95: 701–708, 1988
Locke GR 3rd, Zinsmeister AR, Talley NJ, Fett SL, Melton LJ 3rd: Familial association in adults with functional gastrointestinal disor-ders. Mayo Clin Proc 75: 907–912, 2000
Pata C, Erdal ME, Derici E, Yazar A, Kanik A, Ulu O: Serotonin transporter gene polymorphism in irritable bowel syndrome. Am J Gastroenterol 97: 1780–1784, 2002
Camilleri M, Atanasova E, Carlson PJ, Ahmad U, Kim HJ, Viramontes BE, McKinzie S, Urrutia R: Serotonin-transporter polymorphism pharmacogenetics in diarrhea-predominant irritable bowel syndrome. Gastroenterology 123: 425–432, 2002
Spiller RC, Jenkins D, Thornley JP, Hebden JM, Wright T, Skinner M, Neal KR: Increased rectal mucosal enteroendocrine cells, T lym-phocytes, and increased gut permeability following acute Campy-lobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut 47: 804–811, 2000
Barbara G, De Giorgio R, Deng Y, Vallance B, Blennerhassett P, Collins SM: Role of immunologic factors and cyclooxygenase 2 in persistent postinfective enteric muscle dysfunction in mice. Gas-troenterology 120: 1729–1736, 2001
Tornblom H, Lindberg G, Nyberg B, Veress B: Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irri-table bowel syndrome. Gastroenterology 123: 1972–1979, 2002
Chang L, Heitkemper MM: Gender differences in irritable bowel syndrome. Gastroenterology 123: 1686–1701, 2002
Bromberger JT, Meyer PM, Kravitz HM, Sommer B, Cordal A, Powell L, Ganz PA, Sutton-Tyrrell K: Psychologic distress and nat-ural menopause: a multiethnic community study. AmJ Public Health 91: 1435–1442, 2001
Sato T, Takeichi M, Shirahama M, Fukui T, Gude JK: Doctor-shopping patients and users of alternative medicine among Japanese primary care patients. Gen Hosp Psychiatry 17: 115–125, 1995
Toner BB, Akman D: Gender role and irritable bowel syndrome: literature reviewand hypothesis. AmJ Gastroenterol 95: 11–16, 2000
Parry SD, Stansfield R, Jelley D, Gregory W, Phillips E, Barton JR, Welfare MR: Is irritable bowel syndrome more common in patients presenting with bacterial gastroenteritis? Acommunity-based, case-control study. Am J Gastroenterol 98: 327–331, 2003
Rights and permissions
About this article
Cite this article
Kanazawa, M., Endo, Y., Whitehead, W.E. et al. Patients and Nonconsulters with Irritable Bowel Syndrome Reporting a Parental History of Bowel Problems Have More Impaired Psychological Distress. Dig Dis Sci 49, 1046–1053 (2004). https://doi.org/10.1023/B:DDAS.0000034570.52305.10
Issue Date:
DOI: https://doi.org/10.1023/B:DDAS.0000034570.52305.10