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High Perceived Stress is Associated With Increased Risk of Ulcerative Colitis Clinical Flares
Jenny S Sauk1, Hyo Jin Ryu2, Jennifer S Labus2
1G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California; Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, California.
Summary
High perceived stress in ulcerative colitis patients is linked to increased clinical flares and sympathetic nervous system arousal. This study explored physiological factors associated with stress and flare in UC.
Area of Science:
- Gastroenterology
- Psychoneuroimmunology
- Autonomic Neuroscience
Background:
- Perceived stress (PS) is linked to inflammatory bowel disease (IBD) flares, but associated clinical and physiological markers are unclear.
- Understanding these markers is crucial for managing ulcerative colitis (UC) and its flares.
Purpose of the Study:
- To identify physiological factors linked to perceived stress in UC patients.
- To investigate the relationship between perceived stress, physiological factors, and disease flares in UC.
Main Methods:
- Assessed clinical and behavioral factors, salivary cortisol, and autonomic nervous system activity (heart rate variability, electrodermal activity) in UC patients in remission.
- Monitored patient-reported disease activity (SCCAI) and fecal calprotectin over 1-2 years to identify clinical and biochemical flares.
Main Results:
- Higher perceived stress correlated with a 3.6-fold increased risk of clinical flares, but not biochemical flares.
- Patients with high perceived stress showed greater baseline electrodermal activity, indicating increased sympathetic arousal.
- Fecal calprotectin levels were associated with autonomic measures, suggesting reduced parasympathetic activity during flares.
Conclusions:
- Baseline perceived stress in UC patients is associated with heightened sympathetic arousal.
- Increased perceived stress predicts a greater likelihood of clinical disease flares in ulcerative colitis.
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