A number of investigators over the years have attempted to determine if a relationship exists between flares of inflammatory bowel disease (IBD) and stress. There are many complexities to addressing this issue, including determining the appropriate tools to measure stress, determining the appropriate measures of quantifying a disease flare and also determining the point at which the timing of the stress could be seen to be reasonably related to the onset of the flare. While advances have been made in understanding physiological responses to acute stress, it is unclear whether it is acute, chronic, or recurrent stress that might most impact on a chronic inflammatory disease. In the case of IBD, the disease itself poses a stress to the individual further clouding the issue.
1Departments of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
2Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
3the University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada
Reprint requests and correspondence: Charles N. Bernstein, M.D., Section of Gastroenterology, University of Manitoba, 804F-715 McDermot Avenue, Winnipeg, Manitoba, Canada R3E-3P4.