Copyright
©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Enduring association between irritable bowel syndrome and war trauma during the Nicaragua civil war period: A population-based study
Edgar M Peña-Galo, Daniel Wurzelmann, Javier Alcedo, Rodolfo Peña, Loreto Cortes, Douglas Morgan
Edgar M Peña-Galo, Javier Alcedo, Department of Digestive Diseases, Miguel Servet University Hospital, Zaragoza 50009, Aragon, Spain
Edgar M Peña-Galo, Javier Alcedo, Aragon Health Research Institute, IIS Aragon, Zaragoza 50009, Aragon, Spain
Daniel Wurzelmann, Department of Mental Health, Carolina Partners, Durham, NC 27707, United States
Rodolfo Peña, Department of Data Analysis, CIDE (Research, Development and Epidemiology Center), Tegucigalpa 11101, Francisco Morazán, Honduras
Loreto Cortes, School of Medicine, National Autonomous University of Nicaragua, Leon 21000, Leon, Nicaragua
Douglas Morgan, Department of Gastroenterology and Hepatology, UAB University of Alabama Birmingham, Birmingham, AL 35233, United States
Douglas Morgan, School of Medcine, The University of North Carolina, Chapel Hill, NC 9500, United States
Author contributions: Morgan D and Peña R designed the research; Peña-Galo EM, Peña R, and Cortes L contributed with data acquisition; Peña-Galo EM, Wurzelmann D, Peña R, Alcedo J, and Morgan D analyzed and interpreted of data; Morgan D, and Peña EM wrote manuscript; Peña-Galo EM, Peña R, Alcedo J, Wurzelmann D, Cortes L, and Morgan D performed a critical review.
Supported by the UNC UNAN FGID Epidemiology Study Project, No. 54-1808958.
Institutional review board statement: This study was approved by the Institutional Review Boards of the University of North Carolina, Chapel Hill (#02-MED-461) and UNAN-Leon. All Good Clinical Practice (GCP) standards were followed, including informed consent with each subject, participant confidentiality and anonymized data.
Conflict-of-interest statement: There were no conflicts of interest with respect to industry or government.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Douglas Morgan, FACG, MD, Director, Professor, Department of Gastroenterology and Hepatology, UAB University of Alabama Birmingham, No. 373 Boshell Bldg, UAB, Birmingham, AL 35233, United States. drmorgan@uabmc.edu
Received: July 7, 2023
Peer-review started: July 7, 2023
First decision: August 8, 2023
Revised: September 13, 2023
Accepted: November 27, 2023
Article in press: November 27, 2023
Published online: December 7, 2023
Processing time: 147 Days and 3.5 Hours
ARTICLE HIGHLIGHTS
Research background
Post-traumatic stress disorder (PTSD) in veterans, and the association with irritable bowel syndrome (IBS) is well described, but the impact on civilian population is poor described.
Research motivation
According to United Nations Refugee Agency 108.4 million of people were forced to flee their homes to escape conflicts in 2023. During this exodus the people are exposed to suffer different PTSD. The Nicaraguan population between 1970 and 1988 was part of this worldwide phenomena.
Research objectives
To determinate the association between PTSD and IBS in civilians exposed to war.
Research methods
A nested cross-sectional study was design. A population data set was used to develop a random selection. Different instruments were validated to collect data. The instruments were focused on IBS, PTSD and poverty. Logistic regression model was developed to respond to our aim.
Research results
Positive association between IBS and PTSD by war exposure in civilians was obtained.
Research conclusions
PTSD and IBS symptoms are persistent over the time. The association between then is positive.
Research perspectives
Other populations in the world could be affected by IBS as a result of PTSD originated in different stressful conflicts. Interventions in primary health care could be implemented to improve the gut and mental health.
