Beatrice Renfield Visiting Professor Margaret M. Heitkemper, PhD, RN, FAAN, addressed a crowd of YSN faculty and students on March 31, presenting her discoveries in the field of gastrointestinal health in a presentation entitled, "Bridging Biology and Behavior, Irritable Bowel Syndrome: More than a Gut Feeling."
Heitkemper is Chair of the Department of Biobehavioral Nursing and Health Systems, and Director of the Center for Women's Health, at the University of Washington. She has been continually funded by the National Institutes of Health since 1983 in an ongoing study of women's health, stress, and gastrointestinal function. She traced her research back to the 1970s, when she designed a study of the effects of feeding tubes on nausea, a common problem in hospitals. This eventually led to the first nursing study into the gut function of menstruating women, and that study continues to evolve.
Heitkemper is investigating how stress affects gastrointestinal discomfort and pain. She said that the criteria for irritable bowel syndrome (IBS) was first widely disseminated in 1989, but the definition is still evolving and the causes remain unclear. It now occurs in 10-17% of the US population, and is growing in prevalence across the globe. Managing IBS is of importance to health care management because the disorder accounts for 40% of gastroenterologists' time and involves costly diagnostic procedures. People with IBS experience a low quality of life, even lower even than chronic diseases such as diabetes.
She explained that IBS occurs much more often in women than in men, and more often in younger women. She is working to discover what accounts for these age and gender differences. Gender and socialization may play in role in how much a patient tolerates before seeking help. Hormones seem to play a key role, but are difficult to track, making Heitkemper's ambitious research unusual. For example, in a study of hormones in rats, she found that estrogen did, in fact, inhibit bowel function.
More recently, her project has given patients PDAs to record their symptoms and contributing factors, including stress. While it's clear that stress is key, the question remains: what connects the brain to the gut? She continues in-depth studies of contributing factors such as the adrenal system, childhood trauma, and sleep disorders. Heitkemper and her team are currently conducting intervention research to examine behavioral strategies for reducing symptom distress associated with IBS.