A NURSING STUDY OF GUT FUNCTION IN MENSTRUATING WOMEN
Principal Investigator: Margaret McLean Heitkemper
Affiliation: University of Washington
Abstract: In the current study of gastrointestinal (GI) function and symptoms in menstruating women, approximately 30% reported symptoms compatible with irritable bowel syndrome (IBS). IBS is characterized by upper and,/or lower abdominal pain and change in defecation pattern in the absence of overt pathology, accounts for 100,000 hospital discharges per year and 30-70% of visits to gastroenterologists. Preliminary analysis of our current sample has shown that autonomic nervous system (ANS) arousal, menstrual cycle phase, and psychological distress are associated with such symptoms. Specifically, women who reported recurrent GI symptoms exhibited higher urine catecholamine levels, higher anxiety and more ANS arousal symptom levels particularly at menses. This continuation study is designed to characterize the patterning of GI symptoms with respect to menstrual cycle function, ANS/adrenal arousal, psychological and somatic distress and GI function in menstruating women between 20-40 years of age. Comparisons will be made with 3 groups of women: 1) those with medically diagnosed IBS, 2) those with IBS-like symptoms but not medically diagnosed, and 3) asymptomatic or control. Women will be studied at 3 phases (i.e., menses, follicular, luteal) of the menstrual cycle for 2 menstrual cycles. Both physiological and self-report measures will be used to characterize patterns of GI function, ANS adrenal arousal, and distress. Further, this study includes using an animal model (Sprague-Dawley rat) to validate the, impact of experimentally controlled ovarian steroid hormones (i.e., estrogen, progesterone) on GI function. Both humans and animals will be studied under basal and acute stimulus conditions to examine the impact of stress arousal with varying ovarian hormone levels on GI function (rats) and ANS/adrenal arousal (humans and rats). Knowledge of the relationship among menstrual cycle function, ANS /adrenal arousal, psychological/somatic distress and GI responsivity (symptoms and function) has implications for GI symptom management in menstruating women.
Funding Period: 1984-09-15 - 1996-03-31
more information: NIH RePORT
- Subjective and objective sleep indices in women with irritable bowel syndromeM Heitkemper
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 357266, USA
Neurogastroenterol Motil 17:523-30. 2005..These results highlight the importance of considering the 'first-night effect' in those with IBS and the lack of concordance between self-report and objective indices of sleep in women with IBS...
- Catecholamine and cortisol levels during sleep in women with irritable bowel syndromeR L Burr
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 98195 7266, USA
Neurogastroenterol Motil 21:1148-e97. 2009..Neuroendocrine profiles during sleep may contribute to our understanding of symptom expression in IBS...
- Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome?Margaret M Heitkemper
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington 98125 7266, USA
Gend Med 6:152-67. 2009....
- Gender differences in gastrointestinal, psychological, and somatic symptoms in irritable bowel syndromeKevin C Cain
Department of Biostatistics and Office for Nursing Research, University of Washington, Seattle, WA, USA
Dig Dis Sci 54:1542-9. 2009..The presence of somatic symptoms in postmenopausal women with IBS may challenge clinicians to find suitable therapeutic options...
- Update on irritable bowel syndrome and gender differencesMargaret M Heitkemper
Department of Biobehavioral Nursing, University of Washington, Seattle, WA 98195, USA
Nutr Clin Pract 23:275-83. 2008..This review provides an overview of the pathogenesis of IBS, factors that contribute to gender differences, and current therapeutic approaches for symptom management...
- Irritable bowel syndrome: does gender matter?Margaret Heitkemper
Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 98195, USA
J Psychosom Res 64:583-7. 2008..This mini-review in particular addresses gender differences in visceral sensitivity, motility, and autonomic nervous system balance as potential factors contributing to gender differences in IBS presentation...
- Psychological distress and GI symptoms are related to severity of bloating in women with irritable bowel syndromeHyo Jung Park
Division of Nursing Science, College of Health Science, Ewha Womans University, 11 1 Daehyun Dong, Seoul 120 750, South Korea
Res Nurs Health 31:98-107. 2008..Appraising the level of symptom severity and psychological distress is vital to the selection of appropriate treatment options...
- Autonomic nervous system function during sleep among women with irritable bowel syndromeMonica E Jarrett
Department of Biobehavioral Nursing and Health Systems, University of Washington, Box 357266, Seattle, WA 98125 7266, USA
Dig Dis Sci 53:694-703. 2008..These results suggest that differences in mean level of HRV between predominant bowel groups in IBS patients are large, and that this effect is consistent in the different sleep stages and at different times of night...
- Heart rate variability is related to pain severity and predominant bowel pattern in women with irritable bowel syndromeK C Cain
Department of Biostatistics and Office for Nursing Research, University of Washington, Seattle, WA 98195, USA
Neurogastroenterol Motil 19:110-8. 2007..The relationship of predominant bowel pattern to HRV is qualitatively different in the subgroup of patients with more severe pain than in the subgroup with less severe pain...
- Increased symptoms in female IBS patients with dysmenorrhea and PMSGaylene Altman
Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, 91895, USA
Gastroenterol Nurs 29:4-11. 2006..g., education, diet, relaxation, cognitive restructuring) approach...
- Abdominal pain impacts quality of life in women with irritable bowel syndromeKevin C Cain
Office for Nursing Research and Department of Biostatistics, University of Washington, USA
Am J Gastroenterol 101:124-32. 2006..CONCLUSION: Abdominal pain is the most disruptive IBS symptom. Diarrhea also has an independent and significant impact when it occurs, especially in those with diarrhea-predominant IBS...
- Cognitive behavioral therapy for insomnia improves sleep and decreases pain in older adults with co-morbid insomnia and osteoarthritisMichael V Vitiello
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195 6560, USA
J Clin Sleep Med 5:355-62. 2009..We examined this possibility in a secondary analysis of a previously published randomized controlled trial of cognitive behavioral therapy for insomnia (CBT-I) in patients with osteoarthritis and co-morbid insomnia...