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Kids Take Sickness Cue From Parents

Those whose parents have irritable bowel syndrome miss more school, study shows

TUESDAY, Jan. 29, 2002 (HealthDayNews) -- The behavioral patterns of those with irritable bowel syndrome (IBS) can color their children's experiences of their own illnesses.

That's the conclusion of recent research that compared three years of school absences and found the children of IBS parents missed significantly more school days than other children -- 11.2 days per academic year versus 7.6 days.

The study is part of a larger body of ongoing research looking at how parents' reactions to IBS influence children's perceptions of sickness.

"We're looking at how parents teach their children to respond to illness, and whether the children generally are sicker than children of parents without this problem," explains Rona Levy, a professor of social work at the University of Washington and the author of the study, which was presented recently at a meeting of the American College of Gastroenterology.

IBS causes chronic gastrointestinal problems ranging from constipation to diarrhea, as well as abdominal pain, gas and bloating. The condition is estimated to affect about 4.7 million people, most of them women.

The causes of the condition are not known, but experts believe there is a significant psychological factor at play, with reactions to stress or depression manifesting themselves in the gut more severely than normal.

Although Levy thinks there is probably a genetic factor that determines who gets IBS, she says behavioral responses that are "socially learned" may determine who suffers most from the condition.

">"We're building a case where heredity is a component of IBS," she says. "But what children learn from their parents is a much bigger risk factor for the extent people suffer from this disease, and many other chronic diseases."

Such "learned" behavior is fostered in children through the reactions - - and actions - - of their parents to various situations, says Levy.

"We've all seen a child fall down, and various responses among parents," she explains. "Some will brush the kid off, reassure them that they're fine and move on. Others will dwell more seriously on the event, asking the child where it hurts and perhaps making a much bigger deal out of the situation."

"That's a snapshot example of how parents differ in the ways they teach their children to respond to pain," she says.

Such reactions can show up later in life in the form of IBS, adds Levy, when something like a twinge in the gut that many might notice but ignore sends others to the doctor.

"I think a big factor in why some go in one direction and why some go in another is how we learn to respond to things when we're young," she says.

Dr. Douglas Drossman, an IBS expert and co-director of the University of North Carolina Center for Functional GI Disorders, says the role of family behavioral patterns is recognized as an important factor in IBS.

"The patients with the more severe symptoms seem to come from families where there was a focus on going to the doctor and getting medication when the child got sick, rather than addressing what might be the stressors that are playing a role," he says.

"It's not that the stress is believed to entirely cause the condition," he adds. "But the family may reinforce the severity of the symptoms."

Other contributing factors that are believed to play a role in IBS include hormonal fluctuations, dietary issues and infection in the bowel.

In addition, preliminary research on brain scans indicates certain brain functions that respond to pain may be altered in people with IBS.

"Pain signals are sent to the brain, but typically, the brain can naturally reduce those signals," explains Drossman. "But that ability to turn down such signals may be impaired in people with IBS, and that might be correlated with levels of psychological distress."

Treatment for IBS currently involves a combination of physical and mental therapies, says Drossman.

"In milder cases, sometimes just keeping a diary of daily events and diet, and looking at what the triggers are can help. It could be eating a large fatty meal, drinking lots of soda, stress factors," he says.

In more serious cases, medications treat intestinal symptoms and antidepressants are often prescribed.

The American College of Gastroenterology reports that people with IBS make an estimated 3.5 million physician visits, receive 2.2 million drug prescriptions, and undergo 35,000 hospitalizations in the United States each year.

What To Do

Visit the American College of Gastroenterology for more information on IBS.

Visit the Irritable Bowel Syndrome (IBS) Self Help Group for the latest news and research on IBS.

SOURCES: Interviews with Rona Levy, Ph.D., professor of social work, and psychologist, University of Washington, Seattle; Douglas Drossman, M.D., co-director, University of North Carolina Center for Functional GI Disorders, Chapel Hill, N.C.; Oct. 22, 2001, presentation, annual meeting, American College of Gastroenterology, New York City
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