Hypothalamic-pituitary-adrenal axis dysregulation in women with irritable bowel syndrome in response to acute physical Stress

Leah Z. FitzGerald, Priscilla Kehoe, Karabi Sinha

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21 Scopus citations


Irritable bowel syndrome (IBS) supports the concept of a dysregulated hypothalamic-pituitary-adrenal (HPA) axis. This study investigates the neuroendocrine and psychological responses to the acute physical stress of a lumbar puncture (LP) in women with diarrhea-predominant IBS by assessing central and peripheral HPA activity and affective measures. Blood samples have been collected at baseline and immediately post- and 1 hr following LP from 13 women with IBS and 13 controls. Plasma adrenocorticotropic hormone (ACTH), cortisol, epinephrine, and norepinephrine levels are analyzed. A single measure of cerebrospinal fluid (CSF) concentrations of corticotropin-releasing factor (CRFCSF) and norepinephrine CSF is noted. Affective assessments are used to rate anxiety and depression with the Hospital Anxiety and Depression Scale (HADS) and acute mood state is rated using the Stress Symptom Rating questionnaire (stress, anxiety, anger, arousal). The women with IBS display blunted ACTH and cortisol responses to the LP along with a profile of affective responsiveness suggestive of chronic psychosocial stress, although no CRFCSF differences between groups are observed.

Original languageEnglish
Pages (from-to)818-836
Number of pages19
JournalWestern Journal of Nursing Research
Issue number7
StatePublished - Nov 2009


  • Corticotropin-releasing factor
  • Cortisol
  • HPA axis
  • Irritable bowel syndrome
  • Lumbar puncture


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