Irritable Bowel: A Nursing Study of Symptoms and Coping

Irritable bowel syndrome (IBS) and other functional bowel distress conditions affect predominantly women, interfere with quality of life, cause absence from duty, and challenge health providers in provision of effective care in that few suitable treatments are available. IBS is the most common diagnosis among women seen in civilian gastroenterology clinics and is commonly seen in military clinics as well. There is evidence that many women experience similar symptoms, yet seek no assistance from health providers; these are designated IBS-like ([IBSL]). Differences between IBS and IBSL are not defined, and are the subject of the proposed work. Groups may differ in symptom pattern/intensity or may differ in coping strategies. This study will compare gastrointestinal (GI) symptoms and coping strategies in 3 groups (IBS, IBSL, asymptomatic) of women across 2 menstrual cycles. Because GI symptoms are modulated by menstrual cycle phase, diet, stress exposure and stress response, each of these potentially confounding variables will be measured. GI symptoms are measured via daily health diary; coping strategies are measured via questionnaire; menstrual phase is identified by the lutenizing hormone surge (Ovuquick), first menstruation day, and selected urinary ovarian hormone levels; diet composition is recorded in daily food records; perceived stress exposure is measured with the daily diary and other tools; stress response is measured via urinary content of stress-related hormones. It is hypothesized that IBS and IBSL groups will be similar in symptom intensity and pattern, but will differ in coping strategies. The project will be performed as part of my Masters program. My overall objective is to enhance my understanding of a clinical problem relevant to women's health in which symptoms are modulated by physiologic, psychologic, and environmental stressors. This model of illness is highly relevant to military nursing, where often are seen patients with an underlying physical illness exaggerated under conditions of stress. My specific training objectives are to enhance my knowledge of GI and ovarian hormone physiology, my technical skills performing and evaluating psychological and physiological tests, and to develop an ability to integrate physiological and psychological observations in a manner that informs and advances understanding of underlying disease processes. Training objectives will be achieved by carrying out the study, consulting with experts, assisting with biochemical assays, and formal coursework. The proposed study will contribute importantly to ongoing studies of IBS, and prepare me as an advanced clinician.

Final Report is available on NTRL at: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2009107...