Abstract
Background: Adult IBS has recently been linked to childhood social class in patient samples (1). However, variations in health service use have been reported in relation to both 1BS and social class. Thus, it remains uncertain as to whether childhood social class is directly linked to adult IBS, or is linked to heahh-care seeking for this condition. We aim to assess the influence of the childhood social class on adult 1BS, using population-based data from a New Zealand birth cohort study.
Method: Participants are members of the Dunedin Multidisciplinary Health and Development Study - a longitudinal investigation of health and behavior in a complete birth cohort. The cohort was assembled in 1972-3 and has been followed prospectively to age 26 (n = 980). IBS was classified according to both Rome and Manning Criteria, using self-reported symptom data obtained at age 26 years. Childhood social class was measured at birth, and at ages 3-, 5-, 7-, 9-, 11-, 13- and 15- years, using parental report of occupation. This was assigned according to the highest average socio-economic (SES) level of either parent from all interviews across the first 15 years of life.
Results: Childhood social class was significantly associated with IBS according to Manning Criteria (p=O.05) and Rome II Criteria (p=O.05). The prevailing trend was identical for both measures of IBS in the sex-adjusted models: this trend can be characterised AGA Abstracts A-312 as a general, and near-linear decrease in the odds of 1BS across progressively lower levels of social class. Contrasts with the reference group were significant on all comparisons for Manning Criteria IBS tHigh versus: Upper Middle, p = 0.04; Lower Middle, p = 0.04; Low, p=0.01), and on comparisons involving the two lower social class groups for Rome II Criteria IBS thigh versus: Lower Middle, p=0.03; Low, p=0.03). The associations were attenuated, but not eliminated by further adjustment for Study member's achieved social class in adulthood.
Conclusions: Childhood social class is independently linked to adult IBS. Thus, the social and economic conditions encountered through childhood may play an important etiological role in the pathogenesis of IBS. References 1. Mendall MA, Kumar D. Antibiotic use, childhood affluence and the irritable bowel syndrome (I8S). Euro J Gastmenterol Hepatol 1998; 10: 59-62.