Sexual and physical abuse in women with functional or organic gastrointestinal disorders

Article Abstract:

Functional gastrointestinal disorders are those such as irritable bowel syndrome, nonulcer dyspepsia (abdominal discomfort), and chronic abdominal pain, for which no physiological or anatomical cause is known. The typical patient with these complaints is female and exhibits a particular psychosocial profile. To evaluate whether patients with functional gastrointestinal disorders tend to have histories of physical or sexual abuse (as has been noted in earlier research), 206 women were studied who attended a university-based gastroenterology clinic. They completed a questionnaire that asked about demographic factors, medical symptoms, health care utilization, and sexual and physical abuse. The subjects were mainly white and had a high school education; half were married. They had visited the doctor, on average, slightly less than four times in the six months before the visit where they filled out the questionnaire. Eighty-nine patients (44 percent) reported undergoing physical or sexual abuse in childhood or adulthood, and 11 of the 12 physically abused were also sexually abused. While 35 percent of the abused women had discussed their experiences with a professional person, the majority had not discussed them with their current family. Seventy-five patients received a diagnosis of functional gastrointestinal disorder; their risk for abuse was higher than the risk for patients with organic disorders. They were also more likely to have a history of forced intercourse, frequent physical abuse, abdominal pain, and surgeries. These patients were also more likely to be taking part in psychological counseling. Abused patients had an increased risk for pelvic pain and symptoms in parts of the body other than the abdomen. Care must be taken in interpreting these results because of possible methodological problems. Physicians should determine whether patients with chronic pain or frequent visits have histories of abuse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Child abuse, Abdominal pain, Sexually abused children, Indigestion

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Sexual and physical abuse and gastrointestinal illness: review and recommendations

Article Abstract:

There may be an association between past sexual or physical abuse and current stomach or intestinal disorders. Researchers summarized studies from the current literature on the associations between abuse and stomach and intestinal disorders and presented theories to explain this association. They also suggested ways for primary care physicians to identify abused patients and presented sources of further assistance for these patients. Studies have shown that sexually abused women report significantly more stomach and intestinal illnesses (30.1%-64%) as compared to those with no history of abuse (10.9%-39%). In addition, other studies have found between 26%-44% of patients with stomach and intestinal disorders have a history of sexual abuse. There may be a neurological connection between sexual abuse and later stomach and intestinal illnesses. Intervention with mental health professionals and local support groups may help in both the emotional and physical healing processes.

Psychological aspects, Child sexual abuse, Psychophysiologic disorders, Psychosomatic disorders

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Diagnosing and treating patients with refractory functional gastrointestinal disorders

Article Abstract:

Painful gastrointestinal illness requires conservative medical attention and a strong relationship between patient and physician. Gastrointestinal disorders range from heartburn to dyspepsia or constipation often linked with psychosocial aspects. The physician can ask the patient 12 pertinent questions about pain, stress, family relations, abnormal expectations, and coping behavior. Subsequent referral for psychological treatment may follow such an early evaluation. Beyond that, physicians should acknowledge the pain without overreacting to demands for treatment. Patient education and self-reliance can achieve benefits for people with mild symptoms. More severe cases may need medications and other treatments. Both patient and physician must agree on the treatment of choice. Unless other health care professionals contribute as well, managing gastrointestinal disorders may become fairly time-consuming.

Care and treatment

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