Trauma history and risk of the irritable bowel syndrome in women veterans.
BACKGROUND
Over 1.8 million women in the U.S. are veterans of the armed services. They are at increased risk of occupational traumas, including military sexual trauma.


OBJECTIVE
To evaluate the association between major traumas and irritable bowel syndrome among women veterans accessing Veteran Affairs (VA) healthcare.


METHODS
We administered questionnaires to assess trauma history as well as IBS, post-traumatic stress disorder (PTSD) and depression symptoms to 337 women veterans seen for primary care at VA Women's Clinic between 2006 and 2007. Logistic regression was used to evaluate the association between individual traumas and IBS risk after adjustment for age, ethnicity, PTSD and depression.


RESULTS
Irritable bowel syndrome prevalence was 33.5%. The most frequently reported trauma was sexual assault (38.9%). Seventeen of eighteen traumas were associated with increased IBS risk after adjusting for age, ethnicity, PTSD and depression, with six statistically significant [range of adjusted odds ratios (OR) between 1.85 (95% CI, 1.08-3.16) and 2.6 (95% CI, 1.28-3.67)]. Depression and PTSD were significantly more common in IBS cases than controls, but neither substantially explained the association between trauma and increased IBS risk.


CONCLUSIONS
Women veterans report high frequency of physical and sexual traumas. A lifetime history of a broad range of traumas is independently associated with an elevated risk of the irritable bowel syndrome.
Department of Medicine, Section of Health Services Research, Baylor College of Medicine, Houston, TX, USA.
D L
DL
White
L S
LS
Savas
K
K
Daci
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Elserag
D P
DP
Graham
S J
SJ
Fitzgerald
S L
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Smith
G
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Tan
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El-Serag
D000293:Adolescent; D000328:Adult; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000523:psychology; D016015:Logistic Models; D008875:Middle Aged; D015995:Prevalence; D012306:Risk; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult