Exposure to Severe Wartime Conditions in Early Life Is Associated With an Increased Risk of Irritable Bowel Syndrome: A Population-Based Cohort Study

OBJECTIVES: Stressful events during early life have been suggested to play an important role in the development of the irritable bowel syndrome (IBS). In this study, we evaluate whether an exposure to severe wartime conditions during gestation and in early life are associated with an increased prevalence of IBS. METHODS: We assessed the prevalence of IBS using the Rome II questionnaire among 816 men and women (aged 58 +/- 1 years) who were born as term singletons in Wilhelmina Gasthuis, Amsterdam, The Netherlands around the time of World War II. RESULTS: Of a total of 816 participants, 9.6 % (n = 78, 52F) met the criteria for IBS. Exposure to severe wartime conditions in utero was not associated with the prevalence of IBS in adulthood (8.3 %). Early-life exposure to severe wartime conditions was associated with an increased prevalence of IBS. The prevalence of IBS among individuals exposed up to 0.5 years of age, 1 year of age, and 1.5 years of age was 8.1 %, 12.5 %, and 15.3 %, respectively. The increased IBS prevalence was not associated with an increased stress response. CONCLUSIONS: Our data indicate that exposure to severe wartime conditions in early life is associated with an increased risk of developing IBS. To what extent this is attributable to the stressful environment of war, to severe undernutrition, or to the increased prevalence of infectious diseases is, however, unclear.