Enduring association between irritable bowel syndrome and war trauma during the Nicaragua civil war period:A population-based study

作     者：Edgar M Peña-Galo Daniel Wurzelmann Javier Alcedo Rodolfo Peña Loreto Cortes Douglas Morgan 

作者机构：Department of Digestive DiseasesMiguel Servet University HospitalZaragoza 50009AragonSpain Javier AlcedoAragon Health Research InstituteIIS AragonZaragoza 50009AragonSpain Department of Mental HealthCarolina PartnersDurhamNC 27707United States Department of Data AnalysisCIDE(ResearchDevelopment and Epidemiology Center)Tegucigalpa 11101Francisco MorazánHonduras School of MedicineNational Autonomous University of NicaraguaLeon 21000LeonNicaragua Department of Gastroenterology and HepatologyUAB University of Alabama BirminghamBirminghamAL 35233United States School of MedcineThe University of North CarolinaChapel HillNC 9500United States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2023年第29卷第45期

页      面：5953-5961页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by the UNC UNAN FGID Epidemiology Study Project No.54-1808958 

主　　题：Irritable bowel syndrome Functional gastrointestinal disorders War trauma Civil war Post-traumatic stress disorder Central America 

摘      要：BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is *** experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western *** We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly *** Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in *** exposure was assessed with 10 measures of direct and indirect war trauma and post-war *** exposures were defined by≥3 *** The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent *** populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.