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Parental, Perinatal, and Childhood Risk Factors for Development of Irritable Bowel Syndrome: A Systematic Review
En X S Low1, Maimouna N K Al Mandhari2, Charles C Herndon3
1Department of Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.
Insights
Adverse early life experiences, including parental issues and childhood adversity, are linked to irritable bowel syndrome (IBS). Protective factors like parental warmth may mitigate IBS risk.
Area of Science:
- Gastroenterology
- Developmental Psychology
- Public Health
Background:
- Adverse early life experiences are linked to various chronic diseases.
- Irritable bowel syndrome (IBS), a functional gastrointestinal disorder, may also be influenced by early life adversity.
- This review examines parental, perinatal, and childhood factors associated with IBS development.
Approach:
- A comprehensive literature search was conducted for studies published from 1966 to 2018.
- The search focused on premorbid factors during perinatal and childhood periods, as well as parental influences.
- Twenty-seven studies met the inclusion criteria for the review.
Key Points:
- Identified parental risk factors for IBS include parental IBS, substance abuse, punishment, and rejection.
- Perinatal risk factor identified was low birth weight.
- Childhood risk factors included crowded living conditions, anxiety, depression, and child abuse.
- Protective factors identified were parental emotional warmth and being born to an older mother.
Conclusions:
- Further research is needed to understand fetal and maternal factors contributing to low birth weight and IBS.
- Prospective birth cohort studies collecting biosamples and functional data are crucial.
- Understanding the interplay of genetics, epigenetics, and adversity is key to understanding IBS development.
Background/Aims:
Adverse early life experiences are associated with the development of stroke, cancer, diabetes, and chronic respiratory and ischemic heart diseases. These negative experiences may also play a role in the development of irritable bowel syndrome (IBS)--a functional gastrointestinal disease. This review discusses the research to date on the parental, perinatal, and childhood risk and protective factors associated with the development of IBS.
Methods:
A literature search was completed for studies published between 1966 and 2018 that investigated premorbid factors occurring during the perinatal and childhood periods as well as parental factors that were associated with the development of IBS.
Results:
Twenty-seven studies fulfilled the review criteria. Risk factors that appeared in more than one study included: (1) parental IBS, substance abuse, parental punishment, and rejection as parental risk factors; (2) low birth weight as a perinatal risk factor; and (3) crowded living conditions in low-income families, childhood anxiety, depression, or child abuse as childhood risk factors. Protective factors for IBS were emotional warmth from the parents and being born to an older mother.
Conclusions:
More effort is needed to identify what fetal and maternal factors are associated with low birth weight and IBS. A well-executed prospective birth cohort with a collection of bio-samples and functional data will provide a better understanding of how adversity and the interplay between genetics, epigenetics, and numerous risk factors affect the development of IBS.
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