الفهرس 
subject and methodsOnly 14 pages are availabe for public view
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Abstract
The aim of the present study was o study the relationship of psychological stress with immune function indicators and level of stress hormone cortisol in patients with IBS. The present study comprised 30 patients with IBS (10 patients with constipation predominant, 10 patients with diarrhea predominant and 10 patients with alternating bowel habits as the main complaints of IBS). They were compared with 20 age and sex matched healthy volunteers who served as the control group. Both patients and control were subjected to: A- Full history taking with stress on gastrointestinal symptoms. - Diagnosis of IBS was based on Rome I criteria. B- Special questionnaire to detect stress and its level C- Full clinical examination with stress on palpable colon, organomegally and signs of organ dysfunction D- The following investigations were done for the patients and control. 1- Routine stool analysis. 2- Erythrocyte Sedimentation Rate (ESR) 3- Complete blood picture 4- Fasting serum cortisol. 5- Estimation of T lymphocytes subsets. The present study showed higher prevalence of stress and elevated fasting serum cortisol in IBS patients compared to the control. Stress score and fasting serum cortisol were significantly higher in IBS patients than the control. Percentages of CD3, CD4 and CD8 were significantly lower in patients with IBS compared to the control. Significant negative correlations were found between % of CD3 and CD4 and each of stress score and fasting serum cortisol. A weak negative correlation was found between % of CD8 and each of stress score and serum cortisol in IBS patients. Stress score but not serum cortisol was found to be a strong predictor of the decrease in CD3 and CD4 but not CD8 % . It is concluded that stress by inducing a state of activation of HPA axis depresses the number of T cells of the immune system in patients with IBS. This state of immunosuppression may predispose the patients to various infections, the resulting inflammation may exacerbate and perpetuate the symptoms of IBS in the affected patients.