Histories of sexual victimization in patients with irritable bowel syndrome or inflammatory bowel disease
Authors: E A Walker, W J Katon, P P Roy-Byrne, R P Jemelka, J Russo
Journal: American Journal of Psychiatry (1993)

Two reports have suggested a possible association between a history of sexual trauma and irritable bowel syndrome, but several factors in their study designs limited their generalizability. The authors used a more rigorous methodology to confirm this association.They administered structured psychiatric and sexual trauma interviews to 28 patients with irritable bowel syndrome and 19 patients with inflammatory bowel disease and compared prevalence rates of sexual victimization in the two groups.Compared with patients diagnosed as having inflammatory bowel disease, patients with irritable bowel syndrome had a significantly higher rate of severe lifetime sexual trauma (32% versus 0%), severe childhood sexual abuse (11% versus 0%), and any lifetime sexual victimization (54% versus 5%). The nine patients who had experienced severe lifetime victimization had significantly higher odds ratios for lifetime depression, panic disorder, phobia, somatization disorder, alcohol abuse, functional dyspareunia, and inhibited sexual desire than the 38 patients who had experienced less severe sexual trauma or no trauma. A logistic regression analysis showed that gender, the number of medically unexplained physical symptoms, and self-reported anxiety and hostility accounted for all of the variance in the victimized group.These preliminary results suggest that sexual victimization may be an important factor in the development of irritable bowel syndrome in some patients. Future studies attempting to categorize subgroups of patients with irritable bowel syndrome should inquire into past histories of sexual victimization.This study confirms the previously studied findings by using a more rigorous methodology concerning the association of sexual victimization history and irritable bowel syndrome or inflammatory bowel disease. Structured psychiatric and sexual trauma interviews were given to 28 patients with irritable bowel syndrome and 19 inflammatory bowel disease, and the prevalence rates of sexual victimization in the 2 groups were compared. A logistic regression analysis was performed to summarize the differences between patients who had severe trauma and those who had none, and to account for intercorrelations among the study variables. Results showed that patients with irritable bowel syndrome were more likely to have a history of previous sexual victimization. The odd ratios for current and lifetime psychiatric disorders in the 9 patients who had experienced severe forms of victimization showed that they were at significantly greater risk for affective, anxiety, and somatoform disorders as well as substance abuse and sexual dysfunction. It was also demonstrated that the best predictors of having experienced severe forms of victimization were gender, the number of medically unexplained physical symptoms, and self-reported anxiety and hostility. This study suggests that irritable bowel syndrome may be part of a chronic adjustment to previous sexual victimization in some patients.