Abstract
M.A.
Irritable bowel syndrome [IBS] has been described as a chronic relapsing condition, characterised by a change in bowel habit and abdominal pain, that cannot be explained by an organic disease. Some research indicates that IBS may be psychogenic in origin, however, the aetiology of this complex syndrome is still unclear. Some researchers have postulated that IBS is primarily a motility disorder of the gut, while others have indicated that the symptoms of IBS are mediated by the central nervous system. Thus it is not surprising that the care of patients with IBS poses a particular challenge to physicians, especially because of its biologic and symptomatic heterogeneity and, particularly for patients with refractory symptoms, its association with psychological disturbances. The literature study indicates that there that there may be a possible connection between the ingestive disorders, the menstrual cycle fluctuations associated with premenstrual dysphoric disorder and IBS. All three of these disorders also appear to be mediated, to some extent, by the neurotransmitter serotonin. In terms of these suggested correlations one of the aims of this study was to determine whether blood-serotonin levels significantly influence the symptomatology of IBS. Extensive literature exists documenting the potential role that serotonin plays in gastrointestinal functioning. However, none of the existing studies refer specifically to blood-serotonin levels. Thus the present study attempted to address this problem. A second aim of the present study was to determine the possible serotonergic connection in the ingestive disorders and premenstrual dysphoric disorder in women with IBS. All the subjects were required to go for a blood test in order to determine whether their serotonin levels were low, normal, or high. In addition, three self-report questionnaires were used in this investigation. The Irritable Bowel Syndrome Client Questionnaire; The Eating Disorder Inventory -2, of which four subscales out of 11 subscales were included, namely the Drive for Thinness, Bulimia, Body Dissatisfaction and Introceptive Awareness subscales; and the Premenstrual Assessment Form, of which six subscales out of 18 were included, namely Endogenous Depressive Features, Atypical Depressive Features, Signs of water Retention, General Physical Discomfort, Autonomic Physical Changes and Miscellaneous Physical Changes. In order to address the above mentioned aims, research was conducted at the Research and Counselling Centre for Psychogastroenterology at the Rand Afrikaans University. The Research and Counselling Centre for Psychogastroenterology is a facility developed to investigate the psychological constituents of IBS. Researchers at the centre are aiming to explore the multidimensional components of IBS with the purpose of gaining some understanding into the development and maintenance of this syndrome. A variety of topics are being investigated at the Research and Counselling Centre for Psychogastroenterology, including the role that stress, depression and coping styles play in IBS. Initially a sample group of (N = 60) women with IBS were selected for this research from a population of South Africans who were referred from gastroenterologists and general practitioners to the Centre for Gastroenterology at the Rand Afrikaans University. A number of women (N = 40) without IBS, from the north eastern suburbs of Johannesburg, were also asked to participate in this study in order to compile the comparison group.