Irritable bowel syndrome (IBS) is a common functional gastrointestinal (Gl) disorder that affects 10-17% of women in industrialized nations. The costs of IBS are high, and in 2000 the direct and indirect costs of diagnosis and symptom management of IBS were estimated to be 1.66 billion dollars, making it not only costly to the individual, but also to the health care system. As a competitive renewal application this study proposes to build on our previously funded study in which symptom subtype and severity were related to both sleep characteristics (sleep efficiency, self report of poor sleep) and autonomic nervous system (ANS) balance. The current study is focused on exploring the role of acute stress exposure on night-time sleep, ANS balance, and neuroendocrine markers in women with severe IBS-diarrhea and IBS-constipation. This will be accomplished by describing and comparing women with severe diarrhea-predominant IBS (n=27), severe constipation-predominant IBS (n=27), and Controls (n=27) on measures of vagal tone and physiological arousal indicators under baseline conditions and in response to experimentally induced acture stress (anticipation of public speaking) conditions. Psychophysiological arousal measures include heart rate variability, psychological distress (diary measures, psychiatric history, history of abuse, coping style), and neuroendocrine markers (serial measures of night-time cortisol, ACTH, norepinephrine, epinephrine). Second, groups will be compared on indicators of objective (polysomnograpy) and subjective sleep measures using both self report data and 3 nights in the School of Nursing Sleep Laboratory. Third, this study will explore the relationships of serotonin reuptake transporter protein (SERT) polymorphisms (5- HTTLPR, STin2 VNTR, I425V) to self-reported and polysomnographic sleep, Gl symptoms, history of depression, childhood abuse, hassles severity and frequency, psychiatric distress, ANS and neuroendocrine in women with IBS as well as Controls. This study is important because health care providers working with IBS patients are challenged in that the underlying pathophysiology remains poorly defined and treatments are not universally effective. ? ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR001094-18
Application #
7216328
Study Section
Nursing Science: Children and Families Study Section (NSCF)
Program Officer
Jett, Kathleen
Project Start
1984-09-15
Project End
2010-01-31
Budget Start
2007-02-06
Budget End
2008-01-31
Support Year
18
Fiscal Year
2007
Total Cost
$528,094
Indirect Cost
Name
University of Washington
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
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Kohen, Ruth; Tracy, Julia H; Haugen, Eric et al. (2016) Rare Variants of the Serotonin Transporter Are Associated With Psychiatric Comorbidity in Irritable Bowel Syndrome. Biol Res Nurs 18:394-400
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Heitkemper, Margaret; Cain, Kevin C; Shulman, Robert et al. (2011) Subtypes of irritable bowel syndrome based on abdominal pain/discomfort severity and bowel pattern. Dig Dis Sci 56:2050-8
Heitkemper, Margaret M; Cain, Kevin C; Burr, Robert L et al. (2011) Is childhood abuse or neglect associated with symptom reports and physiological measures in women with irritable bowel syndrome? Biol Res Nurs 13:399-408
Jun, S; Kohen, R; Cain, K C et al. (2011) Associations of tryptophan hydroxylase gene polymorphisms with irritable bowel syndrome. Neurogastroenterol Motil 23:233-9, e116
Heitkemper, Margaret M; Kohen, Ruth; Jun, Sang-Eun et al. (2011) Genetics and gastrointestinal symptoms. Annu Rev Nurs Res 29:261-80

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