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Trauma, Violence, & Abuse, Vol. 8, No. 3, 331-343 (2007)
DOI: 10.1177/1524838007303240
© 2007 SAGE Publications

Relationship of Abuse History to Functional Gastrointestinal Disorders and Symptoms

Some Possible Mediating Mechanisms

Jane Leserman

UNC School of Medicine, University of North Carolina at Chapel Hill

Douglas A. Drossman

UNC School of Medicine, University of North Carolina at Chapel Hill

The primary goals of this article are to review the evidence that links sexual and physical abuse and intimate partner violence (IPV) with functional gastrointestinal (GI) symptoms and disorders and to explore physiological mechanisms that might mediate these health effects. The literature cited in this review has shown strong and consistent relationships of sexual and physical abuse history and IPV with functional GI symptoms and disorders. Among patients with these disorders, abuse history is associated with worse health-related quality of life, more health care utilization, and more pain. Although research has not determined what mechanisms might account for these associations, alterations in psychophysiological and cortico-limbic pain modulatory systems have been suggested. Given the high prevalence of abuse and long-lasting health consequences, referral for psychiatric and psychological treatment makes sense for many patients with abuse history seen within medical settings.

Key Words: functional gastrointestinal disorders • gastrointestinal • intimate partner violence • irritable bowel syndrome • physical abuse • sexual abuse


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