title: Exposure to severe wartime conditions in early life is associated with an increased risk of irritable bowel syndrome: a population-based cohort study.
abstract: OBJECTIVE
  Stressful events during early life have been suggested to play an important role in the development of the irritable bowel syndrome (IBS). In this study, we evaluate whether an exposure to severe wartime conditions during gestation and in early life are associated with an increased prevalence of IBS.
  
  
  METHODS
  We assessed the prevalence of IBS using the Rome II questionnaire among 816 men and women (aged 58+/-1 years) who were born as term singletons in Wilhelmina Gasthuis, Amsterdam, The Netherlands around the time of World War II.
  
  
  RESULTS
  Of a total of 816 participants, 9.6% (n=78, 52F) met the criteria for IBS. Exposure to severe wartime conditions in utero was not associated with the prevalence of IBS in adulthood (8.3%). Early-life exposure to severe wartime conditions was associated with an increased prevalence of IBS. The prevalence of IBS among individuals exposed up to 0.5 years of age, 1 year of age, and 1.5 years of age was 8.1%, 12.5%, and 15.3%, respectively. The increased IBS prevalence was not associated with an increased stress response.
  
  
  CONCLUSIONS
  Our data indicate that exposure to severe wartime conditions in early life is associated with an increased risk of developing IBS. To what extent this is attributable to the stressful environment of war, to severe undernutrition, or to the increased prevalence of infectious diseases is, however, unclear.
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Tamira K
authors.initials: TK
authors.lastname: Klooker
authors.forename: Breg
authors.initials: B
authors.lastname: Braak
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Painter
authors.forename: Susanne R
authors.initials: SR
authors.lastname: de Rooij
authors.forename: Ruurd M
authors.initials: RM
authors.lastname: van Elburg
authors.forename: Rene M
authors.initials: RM
authors.lastname: van den Wijngaard
authors.forename: Tessa J
authors.initials: TJ
authors.lastname: Roseboom
authors.forename: Guy E
authors.initials: GE
authors.lastname: Boeckxstaens
mesh_terms: D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D013312:Stress, Physiological; D013315:Stress, Psychological / Q000150:complications*; D047789:World War II