Post-traumatic Stress and IBD: The Research May Surprise You

Managing inflammatory bowel disease (IBD) is both physically and mentally challenging. While much of the current treatment strategies focus on the physical, new research is showing us just how important the psychological aspects of IBD can be.

A recent study published in the journal Inflammatory Bowel Diseases found that people with IBD can experience post-traumatic stress (PTS) due to their disease experiences.

We interviewed Dr. Taft, PsyD, MIS, a licensed clinical psychologist specializing in the psychological impacts of chronic digestive diseases on the Gastro Girl podcast. Dr. Taft explained about PTS, research evidence, and provided expert advice for those who need help.

What’s the difference between PTS and PTSD?

Many people have heard of post-traumatic stress disorder (PTSD), but you may be wondering why the researchers used the term post-traumatic stress (PTS) in the article.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), PTSD cannot be due to a medical illness. This is why the term PTS is used instead. Dr. Taft tells us that the difference is “semantics in my opinion. All the symptoms are exactly the same”.

What are the symptoms of PTS?

Dr. Taft explains that PTS is a “cluster of symptoms that are commonly reported” and those with ulcerative colitis and Crohn’s disease report similar symptoms. These can include:

  • Avoidance behaviors
  • Changes in mood
  • Sense of being on edge and/or hypervigilance
  • Reliving the trauma

What does the research say about PTS and IBD?

The study supports earlier research that one quarter to one third of people with IBD report significant symptoms of PTS due to their experiences with the disease.

Dr. Taft and her team found that women, racial and ethnic minorities, and those with less than a college degree were at a higher risk of PTS from IBD. They also found that hospitalizations and surgeries were associated with PTS.

What to do if you think you have PTS

If you think you are experiencing symptoms of PTS, it’s important to bring this up to your doctor right away.

Dr. Taft understands that it may be difficult for some people with IBD to discuss these symptoms with their doctor. She tells us that it’s also okay to start by seeking help from a psychologist or social worker who specializes in trauma and provides “trauma-informed therapy”.

If you feel that you need help determining if you have PTS, Dr. Taft suggests filling out questionnaires such as the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) or the PTSD Checklist for DSM-5 (PCL-5). But it’s very important to note that “It’s triggering to fill out these questionnaires” and you should only use them if you are ready to answer these types of questions and start seeking help.

Prevention of PTS in IBD

One of Dr. Taft’s goals is to use the research findings to help raise awareness of PTS in those with IBD. She says that doctors would ideally be screening for PTS early after diagnosis of IBD. They should also be screening at major branch points in treatment, such as hospitalizations and surgeries.

For those who have recently been through a traumatic experience related to their IBD, Dr. Taft says that writing down the experience in detail and/or talking to a trusted friend may help prevent PTS from setting in.

Whether you have just started to notice signs of PTS, or have been struggling for years in silence, help is available. Talk to your doctor or find a trauma-informed mental health professional today to get the help you need!

References

Tiffany H Taft, PsyD, MIS, Sarah Quinton, PsyD, Sharon Jedel, PsyD, Madison Simons, PsyD, Ece A Mutlu, MD, Stephen B Hanauer, MD, Posttraumatic Stress in Patients With Inflammatory Bowel Disease: Prevalence and Relationships to Patient-Reported Outcomes, Inflammatory Bowel Diseases, 2021;, izab152, https://doi.org/10.1093/ibd/izab152

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