Long-term risk of irritable bowel syndrome associated with adverse childhood and adulthood experiences: a large-scale prospective cohort study

The impact of adverse childhood experiences (ACEs), adverse adulthood experiences (AAEs), and their combined effects on the risk of incident irritable bowel syndrome (IBS) remains unclear. We aimed to investigate the risk of IBS associated with ACEs and AAEs. Participants free of IBS with available ACEs and AAEs data were included (N = 126,735). ACEs and AAEs were assessed separately using the Childhood Trauma Screener-5 item and custom-built questions, with different patterns identified through latent profile analysis. The primary endpoint was incident IBS. Cox proportional hazards models were used to estimate the relationship. During a median follow-up of 14.5 years, 2492 (2.0%) incident IBS cases were identified. Overall, 95,040 (75.0%), 3011 (2.4%), 17,409 (13.7%), and 11,275 (8.9%) participants were classified as low ACEs, high physical neglect, high emotional neglect, and high abuse patterns, respectively. Compared with low ACEs, those with high emotional neglect (HR = 1.38, 95%CI: 1.24-1.54) and abuse (HR = 1.64, 95%CI: 1.46-1.84) patterns during childhood showed an increased IBS risk. Similarly, 111,776 (88.2%), 7039 (5.6%), and 7920 (6.2%) participants were classified as low AAEs, high physical neglect, and high abuse. Compared to low AAEs, high physical neglect and abuse in adulthood had a 1.34-fold (95%CI: 1.15-1.56) and 1.54-fold (95%CI: 1.36-1.77) increased IBS risk. Joint analysis indicated that individuals with high abuse or emotional neglect in ACEs, combined with any pattern in AAEs, had a 39-161% higher IBS risk compared to those with low ACEs and AAEs. Both ACEs and AAEs are associated with higher IBS risk, with their joint effects aggravating the risk.