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Journal of Crohn's and Colitis: 9 (12)


Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium


Published on behalf of

Reconsidering the methodology of “stress” research in inflammatory bowel disease

Laurie Keefer, Ali Keshavarzian, Ece Mutlu
DOI: http://dx.doi.org/10.1016/j.crohns.2008.01.002 193-201 First published online: 1 September 2008


Background and aims: The goals of this paper are: 1) to critically review and analyze the methodology of the studies since 1990 linking stress to inflammatory bowel disease; and 2) to make recommendations for future research in this area of research.

Methods: Articles were restricted to empirical reports in the English language with human subjects. Eleven empirical articles were able to answer “How is psychological stress related to inflammation and/or the expression or course of inflammatory bowel disease?”

Results: Studies varied by choice of participant groups, method for classifying disease activity, choice of design, and definition and measurement of stress. Only half of the studies supported the hypothesis that stress affected IBD in some way.

Conclusions: Current methodological limitations in the stress and gut inflammation research have made it difficult for us to ascertain the role of stress in inflammatory bowel disease. Authors provide a checklist of items to consider when designing future studies.

  • Stress
  • Inflammatory bowel disease
  • Ulcerative colitis
  • Crohn's disease
  • Methodology
  • Psychosocial
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