THE EFFECT OF A SELF MANAGEMENT PROGRAM ON CORTISOL LEVELS IN IRRITABLE BOWEL SYNDROME

2.50
Hdl Handle:
http://hdl.handle.net/10755/157481
Type:
Presentation
Title:
THE EFFECT OF A SELF MANAGEMENT PROGRAM ON CORTISOL LEVELS IN IRRITABLE BOWEL SYNDROME
Abstract:
THE EFFECT OF A SELF MANAGEMENT PROGRAM ON CORTISOL LEVELS IN IRRITABLE BOWEL SYNDROME
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Deechakawan, Wimon, MSN, MS, RN
P.I. Institution Name:School of Nursing, University of Washington
Title:Doctoral Student
Contact Address:1959 NE Pacific St, Seattle, WA, 98195, USA
Co-Authors:Margaret M. Heitkemper; Monica E. Jarrett; Kevin C. Cain
PURPOSE: To examine the effect of a comprehensive self management (CSM) program on urinary cortisol levels in men and women with irritable bowel syndrome (IBS) at the 6 month follow-up assessment compared to baseline.
BACKGROUND: Stress may exacerbate IBS symptoms. Patients with IBS report not only chronic gastrointestinal (GI) symptoms but also psychological distress. One possible link between stress and IBS symptoms is the dysregulation of the hypothalamic-pituitary-adrenal axis and subsequent secretion of cortisol. The CSM program significantly decreases GI symptoms and improves quality of life. An intervention study has reported a reduction trend of urinary cortisol levels in women with IBS after treatment. Non-IBS controls report less intense stress and lower levels of daily stress than women with IBS.
METHODS: This secondary analysis used data collected in a randomized controlled trial of 188 women and 33 men with IBS who met Rome II criteria and were 18-70 years of age. The participants that met the eligibility criteria were randomized to either the CSM program in-person or predominantly by telephone or usual care (UC). The first morning urine cortisol data was collected once a week for four weeks during the baseline assessment and during the six month follow-up assessment. Urinary cortisol concentration was divided by urinary creatinine concentration in order to control for urine concentration.
RESULTS: Based on an ANCOVA controlling for baseline, there was no evidence of a significant treatment effect on urinary cortisol. Based on the baseline samples, there was a significant association of cortisol levels with age (p = 0.01); however, the relationship became non-significant when creatinine and gender were included in the model. There was no significant difference in cortisol levels between women and men at baseline and the 6- month follow up. Creatinine levels at baseline and the 6-month follow up data collection point showed a strong association with age and gender: higher levels for men than women (p < .001) at baseline and lower creatinine levels found in older ages (p < .001).
CONCLUSION: Despite marked improvements in psychological distress and GI symptoms, the CSM program showed no effect on cortisol levels in men and women with IBS. Additional work exploring the relationship between the exacerbation of GI symptoms and psychological distress and stress-related hormones e.g., cortisol and catecholamine levels is underway. First void urine cortisol levels may not capture changes in stress activation and additional measures, e.g., salivary cortisol, 24 hr urine cortisol should be explored.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleTHE EFFECT OF A SELF MANAGEMENT PROGRAM ON CORTISOL LEVELS IN IRRITABLE BOWEL SYNDROMEen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157481-
dc.description.abstract<table><tr><td colspan="2" class="item-title">THE EFFECT OF A SELF MANAGEMENT PROGRAM ON CORTISOL LEVELS IN IRRITABLE BOWEL SYNDROME</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Deechakawan, Wimon, MSN, MS, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">School of Nursing, University of Washington</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Doctoral Student</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1959 NE Pacific St, Seattle, WA, 98195, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">wimond@u.washington.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Margaret M. Heitkemper; Monica E. Jarrett; Kevin C. Cain</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE: To examine the effect of a comprehensive self management (CSM) program on urinary cortisol levels in men and women with irritable bowel syndrome (IBS) at the 6 month follow-up assessment compared to baseline. <br/>BACKGROUND: Stress may exacerbate IBS symptoms. Patients with IBS report not only chronic gastrointestinal (GI) symptoms but also psychological distress. One possible link between stress and IBS symptoms is the dysregulation of the hypothalamic-pituitary-adrenal axis and subsequent secretion of cortisol. The CSM program significantly decreases GI symptoms and improves quality of life. An intervention study has reported a reduction trend of urinary cortisol levels in women with IBS after treatment. Non-IBS controls report less intense stress and lower levels of daily stress than women with IBS. <br/>METHODS: This secondary analysis used data collected in a randomized controlled trial of 188 women and 33 men with IBS who met Rome II criteria and were 18-70 years of age. The participants that met the eligibility criteria were randomized to either the CSM program in-person or predominantly by telephone or usual care (UC). The first morning urine cortisol data was collected once a week for four weeks during the baseline assessment and during the six month follow-up assessment. Urinary cortisol concentration was divided by urinary creatinine concentration in order to control for urine concentration. <br/>RESULTS: Based on an ANCOVA controlling for baseline, there was no evidence of a significant treatment effect on urinary cortisol. Based on the baseline samples, there was a significant association of cortisol levels with age (p = 0.01); however, the relationship became non-significant when creatinine and gender were included in the model. There was no significant difference in cortisol levels between women and men at baseline and the 6- month follow up. Creatinine levels at baseline and the 6-month follow up data collection point showed a strong association with age and gender: higher levels for men than women (p &lt; .001) at baseline and lower creatinine levels found in older ages (p &lt; .001). <br/>CONCLUSION: Despite marked improvements in psychological distress and GI symptoms, the CSM program showed no effect on cortisol levels in men and women with IBS. Additional work exploring the relationship between the exacerbation of GI symptoms and psychological distress and stress-related hormones e.g., cortisol and catecholamine levels is underway. First void urine cortisol levels may not capture changes in stress activation and additional measures, e.g., salivary cortisol, 24 hr urine cortisol should be explored. <br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:54:41Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:54:41Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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