Like a Punch in the Gut: A Novel Perspective On Annual Recurrences of Ulcerative Colitis.

IF 1.8 Q3 GASTROENTEROLOGY & HEPATOLOGY Crohn's & Colitis 360 Pub Date : 2024-10-17 eCollection Date: 2024-10-01 DOI:10.1093/crocol/otae050
Sasha Johnston, Aileen Fraser, Carrie Biddle, Jennifer Wild
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引用次数: 0

Abstract

Background: Ulcerative colitis (UC), a chronic inflammatory bowel disease, causes stomach pain, diarrhea, and rectal bleeding. The exact cause is unknown, but it is thought to involve genetic, environmental, and psychological factors. Some people experience annual flare-ups without obvious reason. This article adopts a theory-driven approach to consider how and why past traumatic events may contribute to annual flare-ups.

Methods: We applied learning theory, which explains the development of re-experiencing phenomena in post-traumatic stress disorder (PTSD), to better understand the occurrence of annual flares in patients living with UC.

Results: Two possibilities emerged in which associative learning may contribute to annual UC flares. First, flare-ups could be a physical response to sensory cues in the present that overlap with trauma experienced at the first onset of UC. Annual episodes may strengthen the UC flare as a learned physiological response to trauma reminders. Second, flare-ups may result from elevated stress due to trauma re-experiencing at anniversaries. Sensory features of the initial UC trauma may be associated with strong reactions, which generalize to similar stimuli, triggering re-experiencing symptoms and increasing psychological stress. Elevated stress raises glucocorticoid levels, promoting UC-specific inflammation. Stimulus discrimination from cognitive therapy for PTSD may help to over-ride the associations that have formed between sensory features of past trauma, linked reactions, and similar cues in the present.

Conclusions: Research is needed to understand how traumatic events influence the onset and recurrence of ulcerative colitis, as well as the potential benefits of stimulus discrimination for reducing the frequency of annual flares.

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就像给肠子来了一拳溃疡性结肠炎年度复发的新视角
背景:溃疡性结肠炎(UC)是一种慢性炎症性肠病,会引起胃痛、腹泻和直肠出血。确切病因尚不清楚,但认为与遗传、环境和心理因素有关。有些人每年都会在没有明显原因的情况下发作。本文采用理论驱动的方法,探讨过去的创伤性事件如何以及为何会导致每年复发:我们运用学习理论(该理论解释了创伤后应激障碍(PTSD)中再体验现象的发展)来更好地理解 UC 患者每年复发的原因:结果:联想学习有两种可能导致 UC 每年复发。首先,复发可能是对当前感觉线索的一种生理反应,这种感觉线索与 UC 初发时经历的创伤重叠。每年的发作可能会加强 UC 的复发,这是对创伤提醒的一种习得性生理反应。其次,复发可能是由于在周年纪念日重新经历创伤而导致压力升高。最初的 UC 创伤的感官特征可能与强烈的反应有关,这种反应会泛化到类似的刺激,引发再体验症状并增加心理压力。压力增加会提高糖皮质激素水平,促进 UC 特异性炎症。创伤后应激障碍认知疗法中的刺激辨别法可能有助于消除过去创伤的感官特征、相关反应和当前类似线索之间形成的联想:需要开展研究,以了解创伤事件如何影响溃疡性结肠炎的发病和复发,以及刺激辨别对降低每年复发频率的潜在益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Crohn's & Colitis 360
Crohn's & Colitis 360 Medicine-Gastroenterology
CiteScore
2.50
自引率
0.00%
发文量
41
审稿时长
12 weeks
期刊最新文献
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