Childhood Trauma and IBD: Is There a Connection?
"What causes ulcerative colitis?" This question is most often asked when I explain my inflammatory bowel disease. Although no one can pinpoint the exact cause, many experts believe some of the origins might be connected to a person's genes, immune system, environment, and changes to gut microbiome.
But another source has also been researched. It is one that rarely gets mentioned. As an advocate of adverse childhood experiences, I believe this potential cause needs highlighted.
The link between childhood trauma and long-term health
As a high school teacher in the U.S., I have many students who are either part of the foster care system or are living with relatives who are not their parents. I hear their stories. They write about the trauma, abuse, and neglect that sent them into foster care or into living with grandparents, aunts or uncles, family friends, etc.
If there's one point most adults can agree on, no child should ever have to experience abuse or neglect. Child abuse and neglect create not only lasting mental harm but also long-term health impacts.
Can childhood trauma contribute to the cause of IBD?
In 2015, a study out of the University of Toronto found that adults with a history of childhood abuse were twice as likely to end up with ulcerative colitis compared to those individuals who hadn't suffered abuse.1
If this study’s results of 22,000 Canadian adults was published in 2015, why hasn't this information disseminated worldwide? Why is no one talking about the greater vulnerability of developing UC because of childhood abuse and trauma?
When I went looking for the most recent research, I found many articles detailing the 2015 Canadian study on this topic. I wondered, "What about current reports? Is anyone investigating the trauma-gut connection today?"
It's an area that needs more research
Based on my time surveying medical research, I found only one recent article. Again, Canada is the only source of this link. From the Journal of the Canadian Association of Gastroenterology (JCAG), I found a published research article dated August 2023.
One article. That's it. This one article highlights two studies that occurred at two separate times – in 2019 and in 2021.
Based on these studies, they found that the brain-gut axis can explain the development of IBD. In short, individuals who experienced childhood traumas can also experience adverse gut microbiome changes that may also lead to dysfunctional immune responses and inflammation. This link suggests a greater likelihood of developing depression and other mental health issues.
While there is no definitive cause-effect evidence linking childhood trauma to IBD, the research indicates a greater chance of having IBD due to inflammation from the psychological wound created by trauma, abuse, or neglect.1
Childhood trauma connected to autoimmune diseases
As a well-known Hungarian Canadian physician, Dr. Gabor Maté writes and speaks of the potential lifelong effects on physical and mental health derived from childhood trauma. His research and work studies the trauma experienced by his patients that lead to autoimmune disease, addiction, and other health conditions. In his words, he stresses that "emotions and physiology are inseparable...it's all one system."2
As an autoimmune disease, UC results from an unnecessary immune reaction that leads to inflammation in the colon and rectum. Why does this happen? Isn't the immune system meant to fight off infections? For those with IBD, the opposite occurs. Autoimmune diseases attack healthy tissues in the body instead.
Returning to the research and Dr. Maté, since the mind and body are inseparable, toxic stress and trauma can indeed lead to health issues such as autoimmune diseases.2
Coping with trauma and gastrointestinal issues
So, what can a person do if they experience toxic stress, abuse, or trauma in childhood? How can IBD be avoided?
Back to the Canadian research, their studies found that by confiding to a trusted friend or family member about the trauma can reduce mental health and gastrointestinal issues for those with IBD. Compassionate discussions surrounding trauma or abuse reduce psychophysiological tension within the body.1
In other words, if you fix the mind, you help the body. Those individuals with a history of trauma or neglect need to let in what is healthy to ward off the toxins and stress.
Ignoring the pain
But what is human tendency? Most often, people who "suffer in silence" or stuff down their feelings end up with more bodily illnesses or issues. If an individual disables their emotions, the direct result is disabling the immune system. This could explain how Crohn's and colitis manifest as autoimmune diseases.
Because I have lived with UC since my early teen years, I believe in the power of getting the message out. Childhood trauma and neglect causes long-term health issues. Events that occur during the first 18 years of a person's life impact the body. As a public educator, I do my best to discuss and address adversity with my students as they prepare to graduate. Educating the next generation before they become parents is vital.
The Adverse Childhood Experience (ACE) questionnaire
In addition, I believe it's important that physicians – especially pediatricians – address the effects of trauma with their patients. How easy it would be to screen patients with the Adverse Childhood Experience (ACE) quiz. This assessment is found for free online.3
If doctors would include this short 10-question quiz in their routine examinations, then maybe they could advise patients on how health problems such as IBD could be avoided. A multi-disciplinary approach could also be prescribed for patients living in toxic stress environments.
We really don't know the underlying causes of IBD
Now, I don't believe this research to be the conclusion. Maybe genes and the environment are greater factors for causing IBD. The bottom line is that no one knows for certain. But considering trauma as a source is worth pursuing.
So, through writing, I ask that everyone start the discussion about childhood trauma. Educating others is essential in reducing adult health issues. If the body keeps score, why are we not fighting to reduce trauma and help children all at once?
How can you help get the word out about adversity and the IBD connection? Please leave your thoughts and comments below. It takes everyone to prevent suffering in silence.
"Having an ACE score of 2 or more doubles someone's likelihood of developing an autoimmune disease." –Dr. Nadine Burke Harris
How open are you about being diagnosed with IBD?