Untangling Comorbid Irritable Bowel Syndrome and Psychiatric Disorders

Author(s):  
Mihaela Fadgyas Stanculete ◽  
Dan L. Dumitrascu

Irritable bowel syndrome (IBS) is the most frequent and well-studied functional gastrointestinal disorder. Being a condition for which the clinical practitioner trained according to the traditional biomedical paradigm cannot detect any organic or significant biochemical findings, it is frequently managed with reduced interest and referred to a psychiatrist. The psychiatrist’s participation in the management of some IBS patients is critical and may improve the diagnosis of mental comorbidities, which are frequent in IBS, as well as the therapy. Pain is an essential feature of IBS. When pain becomes chronic, there is relevant evidence of functional reorganization of the brain. Many studies have highlighted the importance of psychological factors and personality traits in the modulation of pain expression. There is also substantial evidence that chronic pain is associated with mental disorders and substance abuse. This chapter provides a review of comorbidities in IBS at the crossroad of psychiatry with gastroenterology.

2020 ◽  
Vol 08 (11) ◽  
pp. 5100-5104
Author(s):  
Laveena T P

Irritable bowel syndrome is a common functional gastrointestinal disorder with no identifiable structural abnormality. It is characterized by abdominal pain or discomfort and altered bowel habits as major symp-toms. IBS accounts for more than 40% of new referrals to gastroenterology outpatient clinics. Diagnosis is done by Rome IV criteria. Etiology and pathogenesis is not clearly understood. In Ayurveda it can be man-aged with the concept of Grahani. The basic Samprapthi is at the level of Grahani and Pakwasaya which is as a result of Agnidushti. The symptoms of IBS are Tridoshaja with a Vatha predominance. Vatha has Sthanika importance also as Pakwasaya is the seat of Vatha. So, medicines with Deepana, Pachana, Anu-lomana and Grahi properties are ideal. Satwavajaya Chikitsa (psychotherapy) is helpful because of the involvement of psychological factors. Diet and lifestyle modifications with exercises and relaxation tech-niques have added benefit in the management since it has a chronic and relapsing nature.


Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 649
Author(s):  
Luis Alberto Sánchez-Vargas ◽  
Karina Guadalupe Hernández-Flores ◽  
Francisco Javier Cabrera-Jorge ◽  
José María Remes-Troche ◽  
Job Reyes-Huerta ◽  
...  

Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten in genetically predisposed individuals. In contrast, irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting the large intestine, without an autoimmune component. Here, we evaluated the prevalence of IgA and IgG antibodies to maize zeins (AZA) in patients with CD and IBS. Using an in-house ELISA assay, the IgA and IgG anti-zein antibodies in the serum of 37 newly diagnosed CD (16 biopsy proved and 21 serological diagnosis) and 375 IBS patients or 302 healthy control (HC) subjects were measured. Elevated levels of IgA AZA were found in CD patients compared with IBS patients (p < 0.01) and HC (p < 0.05). CD patients had the highest prevalence (35.1%), followed by IBS (4.3%) and HCs (2.3%) (p < 0.0001). IgG AZA antibodies were not found in any CD patients, IBS patients, or HC subjects. A significant positive correlation was found between IgA AZA with IgA anti-gliadin (AGA, r = 0.34, p < 0.01) and IgA anti-deaminated gliadin peptides (DGP, r = 0.42, p < 0.001) in the celiac disease group. Taken together, our results show for the first time a higher prevalence of AZA IgA antibodies in newly diagnosed CD patients than in IBS patients, confirming a biased immune response to other gliadin-related prolamins such as maize zeins in genetically susceptible individuals.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1506
Author(s):  
Annamaria Altomare ◽  
Claudia Di Rosa ◽  
Elena Imperia ◽  
Sara Emerenziani ◽  
Michele Cicala ◽  
...  

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. Gut microbiota, which acts as a real organ with well-defined functions, is in a mutualistic relationship with the host, harvesting additional energy and nutrients from the diet and protecting the host from pathogens; specific alterations in its composition seem to play a crucial role in IBS pathophysiology. It is well known that diet can significantly modulate the intestinal microbiota profile but it is less known how different nutritional approach effective in IBS patients, such as the low-FODMAP diet, could be responsible of intestinal microbiota changes, thus influencing the presence of gastrointestinal (GI) symptoms. The aim of this review was to explore the effects of different nutritional protocols (e.g., traditional nutritional advice, low-FODMAP diet, gluten-free diet, etc.) on IBS-D symptoms and on intestinal microbiota variations in both IBS-D patients and healthy subjects. To date, an ideal nutritional protocol does not exist for IBS-D patients but it seems crucial to consider the effect of the different nutritional approaches on the intestinal microbiota composition to better define an efficient strategy to manage this functional disorder.


2018 ◽  
Vol 31 (2) ◽  
pp. e13509 ◽  
Author(s):  
John M. Hollier ◽  
Miranda A. L. van Tilburg ◽  
Yan Liu ◽  
Danita I. Czyzewski ◽  
Mariella M. Self ◽  
...  

2018 ◽  
Vol 64 (5) ◽  
pp. 1288-1295 ◽  
Author(s):  
Keren Hod ◽  
Yehuda Ringel ◽  
Miranda A. L. van Tilburg ◽  
Tamar Ringel-Kulka

2021 ◽  
Vol 12 ◽  
Author(s):  
Sik Yu So ◽  
Tor C. Savidge

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in disease onset and symptoms severity. This review considers sex steroids and their involvement in IBS symptoms and the underlying disease mechanisms. Estrogens and androgens play important regulatory roles in IBS symptomology, including visceral sensitivity, gut motility and psychological conditions, possibly through modulating the gut-brain axis. Steroids are regulators of hypothalamic-pituitary-adrenal activity and autonomic nervous system function. They also modulate gut microbiota and enteric nervous systems, impacting serotonin and mast cell signaling. Sex steroids also facilitate bidirectional cross-talk between the microbiota and host following bacterial transformation and recycling of steroids by the intestine. The sex-specific interplay between sex steroids and the host provides neuroendocrinology insight into the pathophysiology, epigenetics and treatment of IBS patients.


2021 ◽  
Author(s):  
Roberto Catanzaro ◽  
Alfio Maugeri ◽  
Morena Sciuto ◽  
Fang He ◽  
Baskar Balakrishnan ◽  
...  

The gastrointestinal pathologies have increased over the last years. The clinical pictures of inflammatory and irritable bowel disease might overlap, leading to expensive and invasive tests. Our study aims to investigate fecal calprotectin as an effective tool for differential diagnosis of gastrointestinal disorders. Two hundred fifty-six patients with the diagnosis of the gastrointestinal disorder and subjected to colonoscopy were collected for the statistical analysis of fecal calprotectin. The differential diagnosis of intestinal inflammation or non-inflammation was performed according to the Receiver Operating Characteristic (ROC) curve that outlines the Area Under Curve (AUC), Sensitivity (Se), Specificity (Sp). Fecal calprotectin was significantly elevated in patients with inflammatory bowel disease compared with patients with irritable bowel syndrome. Especially, the mean values of fecal calprotectin were 522 g/g (IQR=215-975) and 21 g/g (IQR=14-34.5) in patients with and without inflammation, respectively (P<0.0001). AUC value of fecal calprotectin was 0.958 (Se=88.9%, Sp=91.1%, with a cut-off value of 50 g/g) for differentiating between inflammatory bowel disease and irritable bowel syndrome. Fecal calprotectin seems to be a non-invasive and inexpensive biomarker useful for the purpose of a differential diagnosis between inflammatory bowel disease and irritable bowel syndrome.


Author(s):  
A.V. Zubarenko ◽  
V.V. Luzan ◽  
T.Yu. Kravchenko ◽  
G.K. Kopiyka ◽  
V.I. Martyuk

Functional gastrointestinal disorders are considered as a clinical variant of the interaction between psychosocial factors and gastrointestinal tract physiology implemented through the "brain - intestine" axis. The purpose of the study was to investigate psychological peculiarities of children with irritable bowel syndrome. The study included 68 children aged from 14 to 18 years with the confirmed diagnosis of irritable bowel syndrome. To determine the type of character accentuation, the Schmishek -Leonhard test questionnaire (child version) was used. The SCL-90-R test questionnaire (by L. Derogatis method) was applied to determine psycho-emotional disorders. The study has found out the majority of patients have certain psycho-emotional disorders. The group of children with irritable bowel syndrome, who were experiencing constipation, more frequently demonstrated an emotional type of character accentuation and a somatized and depressed type of psychological disorders. The patients with irritable bowel syndrome and diarrhoea had cycloid and demonstrative types of character accentuation and demonstrated an anxious type according to the questionnaire. The patients with mixed bowel rhythms exhibited features of a cycloid, emotional, and pedantic type of character accentuation. Depression, anxiety, somatised types were reported as manifestations of psychological disorders.


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