title: Perceived Stress in Patients with Common Gastrointestinal Disorders: Associations with Quality of Life, Symptoms and Disease Management.
abstract: OBJECTIVE
  Research supports relationships between stress and gastrointestinal (GI) symptoms and disorders. This pilot study assesses relationships between perceived stress, quality of life (QOL), and self-reported pain ratings as an indicator of symptom management in patients who self-reported gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD).
  
  
  RESULTS
  In the full sample (n = 402) perceived stress positively correlated with depression (r = 0.76, P < .0001), fatigue (r = 0.38, P < .0001), sleep disturbance (r = 0.40, P < .0001), average pain (r = 0.26, P < .0001), and worst pain (r = 0.25, P < .0001). Higher perceived stress also correlated with lower mental health-related QOL. Similar correlations were found for the participants with GERD (n = 188), IBS (n = 132), and IBD (n = 82). Finally, there were significant correlations in the GERD cohort between perceived stress, and average pain (r = 0.34, P < .0001) and worst pain (r = 0.29, P < .0001), and in the IBD cohort between perceived stress, and average pain (r = 0.32, P < .0001), and worst pain (r = 0.35, P < .01).
  
  
  CONCLUSIONS
  Perceived stress broadly correlated with QOL characteristics in patients with GERD, IBS, and IBD, and their overall QOL was significantly lower than the general population. Perceived stress also appeared to be an indicator of symptom management (self-reported pain ratings) in GERD and IBD, but not IBS. While future research using objective measures of stress and symptom/disease management is needed to confirm these associations, as well as to evaluate the ability of stress reduction interventions to improve perceived stress, QOL and disease management in these GI disorders, integrative medicine treatment programs would be most beneficial to study.
authors.affiliation: Nutrition Sciences Department, Drexel University, Philadelphia, PA. Electronic address: EdmanWellness@comcast.net.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Edman
authors.affiliation: Department of Psychology, College of Science and Mathematics, Rowan University, Glassboro, NJ.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Greeson
authors.affiliation: Duke Clinical Research Institute, Duke University, Durham, NC.
authors.forename: Rhonda S
authors.initials: RS
authors.lastname: Roberts
authors.affiliation: Main Line Gastroenterology Associates, Malvern, PA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Kaufman
authors.affiliation: UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA.
authors.forename: Donald I
authors.initials: DI
authors.lastname: Abrams
authors.affiliation: Division of General Internal Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Rowena J
authors.initials: RJ
authors.lastname: Dolor
authors.affiliation: Osher Center for Integrative Medicine, Vanderbilt University, Schools of Medicine and Nursing, Nashville, TN.
authors.forename: Ruth Q
authors.initials: RQ
authors.lastname: Wolever
mesh_terms: D015746:Abdominal Pain / Q000523:psychology; D000328:Adult; D003863:Depression; D019468:Disease Management; D005221:Fatigue; D005260:Female; D005767:Gastrointestinal Diseases / Q000473:pathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D057566:Self Report; D012890:Sleep; D013315:Stress, Psychological
keywords: gastroesophageal reflux disease; inflammatory bowel disease; irritable bowel syndrome; perceived stress; quality of life; stress management