Role of Stress in Functional Gastrointestinal Disorders

作者：Hubert Mönnikes, Johannes J. Tebbe, M. Hildebrandt, Petra Arck, Engin Osmanoglou, Matthias Rose, Burghard F. Klapp, Bertram Wiedenmann, I. Heymann‐Mönnikes · 发表于：Digestive Diseases · 年份：2001 · DOI：10.1159/000050681 · 被引用次数：296 · 研究领域：Gastrointestinal motility and disorders、Stress Responses and Cortisol、Health, psychology, and well-being

Psychological stress is widely believed to play a major role in functional gastrointestinal (GI) disorders, especially irritable bowel syndrome (IBS), by precipitating exacerbation of symptoms. The available data clearly demonstrate that inhibition of gastric emptying and stimulation of colonic transit is the most consistent pattern in the motility response of the GI tract to acute or short-term stress. Thus, one might propose that these alterations might play a pathophysiological role in dyspeptic symptoms and alterations in stool frequency and consistency in patients with stress-related functional GI disorders. Taken together, the above-mentioned studies suggest that the colonic motor response to stress is exaggerated in IBS. There is evidence that an increased emotional response is associated with this difference in colonic, and perhaps also gastric motor responses to certain stressors. However, almost no valid data are available so far from human studies addressing the question if differences in motility responses to stress between patients with functional GI disorders and healthy subjects are due to an altered stress response associated with an imbalance of the autonomic nervous system or increased stress susceptibility. We can summarize that in experimental animals the most consistent pattern of GI motor alterations induced by various psychological and physical stressors is that of delaying gastric emptying and accelerating colonic transit. Endogenous corticotropin-rele...