title: Increased abdominal pain during final examinations.
abstract: Anecdotes and animal experiments alike suggest that physiological and psychological stress can profoundly alter gastrointestinal function. However, few studies have examined, in humans, real-world stress to see if free-living persons exhibit gut alterations similar to those produced in the laboratory. To investigate this possibility, we studied 16 medical and premedical students during final written examinations. As compared to a control day, the examination created a classic stress response: elevated serum cortisol (16 +/- 1 to 21 +/- 3 micrograms/dl; P < 0.05), ACTH (31 +/- 1 to 33 +/- 1 pg/ml; P < 0.05), heart rate (72 +/- 3 to 79 +/- 3 beats/min; P < 0.05), arterial blood pressure (systolic pressure 106 +/- 2 to 120 +/- 2 torr; P < 0.05; diastolic pressure 72 +/- 2 to 77 +/- 1 torr; P < 0.05), and subjective anxiety (raw score 28 +/- 2 to 47 +/- 3; P < 0.0001). In contrast, subjects displayed identical orocecal liquid transit time (of 0.36 g/kg lactulose in a 240-ml, 250-kcal liquid meal) under control (103 +/- 8 min) and examination conditions (106 +/- 8 min; P = NS). Mean subjective reports of gas, diarrhea, and borborygmi were unchanged on the day of the experiment, although the examination did increase reported abdominal pain (from 0.5 +/- 0.4 to 2.1 +/- 0.5 on a 0-5 analog scale; P < 0.05). We conclude that examination stress in humans can increase gastrointestinal symptoms without altering orocecal transit.
authors.affiliation: Medical Sciences Program, Indiana University, Bloomington 47405.
authors.forename: A
authors.initials: A
authors.lastname: Harris
authors.forename: B J
authors.initials: BJ
authors.lastname: Martin
mesh_terms: D015746:Abdominal Pain / Q000523:psychology*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D001007:Anxiety / Q000209:etiology; D001794:Blood Pressure / Q000502:physiology; D004521:Educational Measurement; D005772:Gastrointestinal Transit / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology; D013337:Students, Medical / Q000523:psychology
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone