Rotating shift workers at an increased risk of irritable bowel syndrome

Employees who work rotating shifts face a significantly higher risk of developing irritable bowel syndrome and abdominal pain than individuals working a standard daytime schedule.

IBS is the most common functional bowel disorder, and researchers said it is difficult to identify because it is diagnosed by clinical symptoms rather than tests. Symptoms include recurrent episodes of abdominal pain or cramping in connection with altered bowel habits.

"We know that people participating in shift work often complain of gastrointestinal symptoms such as abdominal pain, constipation and diarrhea," said Sandra Hoogerwerf, assistant professor of internal medicine at the University of Michigan Medical School and lead author of the study. "These are the same symptoms of IBS."

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For the study, published in the American Journal of Gastroenterology, Hoogerwerf and her colleagues evaluated nurses classified into three groups -- 214 working permanent day shifts, 110 working permanent night shifts, and 75 working rotating shifts between day and night -- based on self-reported abdominal symptoms and sleep quality. More than 85 percent of the participants were women. The findings suggested that nurses participating in shift work, particularly those who participate in rotating shift work, have a higher prevalence of IBS and abdominal pain. Researchers said this association was independent of sleep quality.

"We know the colon has its own biological clock, and that's what increases the likelihood of having a bowel movement in the first six hours of the day," Hoogerwerf said. "Shift work can cause chronic disruption of that biological rhythm, resulting in that clock to constantly be thrown off and needing to adjust, creating symptoms of diarrhea, bloating, constipation, and abdominal pain and discomfort."

Researchers said their study suggests that sleep disturbances do not completely explain the existence of IBS or abdominal pain associated with shift work.

"The question now for further research is if IBS and abdominal pain is an underlying manifestation of a circadian rhythm disorder," Hoogerwerf said.

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June 24, 2010

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