The role of gastrointestinal specific anxiety and alexithymia as predictors of the severity of irritable bowel syndrome in women

2021 ◽  
Vol LIII (1) ◽  
pp. 34-40
Author(s):  
Aleksey I. Melehin
Keyword(s):  
Irritable Bowel Syndrome ◽  
Rating Scale ◽  
Emotional Awareness ◽  
Sensitivity Index ◽  
Visceral Sensitivity ◽  
Symptoms Of Depression ◽  
Gastrointestinal Symptom Rating Scale ◽  
Severity Of The Disease ◽  
Irritable Bowel

Aim. To analyze the role of gastrointestinal specific anxiety and alexithymia in predicting the severity of the disease in 194 women with moderate to severe IBS with refractory course (average duration of the disease 38.4 months). Methods of investigation. Gastrointestinal Symptom Rating Scale-IBS (GSRS-IBS), Irritable Bowel Syndrome Severity Scoring System (IBS-SSS), Visceral Sensitivity Index (VSI), TAS-20, HADS, and SF-12. Results. It was shown that in women, the severity of irritable bowel syndrome and the risks of refractory course are closely related to high alexithymia and uncontrolled gastrointestinal specific anxiety, which are also related to each other. Patients with severe IBS significantly differ from patients with moderate symptomocoplex manifestations (pain, bloating, diarrheal manifestations), satisfaction with the quality of life, pronounced symptoms of depression, visceral sensitivity and alexithymia, which contributes to the formation of a number of therapeutic barriers. Regression analysis showed that the severity of IBS was equally predicted by presence of alexithymia and gastrointestinal specific anxiety in the patient. Conclusions. Alexithymia, especially the difficulty of expressing negative emotions (for example, irritation, anger), describing feelings, desires to other people, was a stronger factor in women predicting the severity of IBS compared to gastrointestinal specific anxiety. The presented symptomatic picture of alexithymic manifestations in patients with IBS shows that violations of emotional awareness affect the pathogenesis, the spectrum of reinsurance and avoidance behavior.

The Central Role of Gastrointestinal-Specific Anxiety in Irritable Bowel Syndrome: Further Validation of the Visceral Sensitivity Index

2007 ◽  
Vol 69 (1) ◽  
pp. 89-98 ◽  
Author(s):  
Jennifer S. Labus ◽  
Emeran A. Mayer ◽  
Lin Chang ◽  
Roger Bolus ◽  
Bruce D. Naliboff
Keyword(s):  
Irritable Bowel Syndrome ◽  
Sensitivity Index ◽  
Visceral Sensitivity ◽  
Irritable Bowel

scholarly journals Somatization in patients with predominant diarrhoea irritable bowel syndrome: the role of the intestinal barrier function and integrity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura Prospero ◽  
Giuseppe Riezzo ◽  
Michele Linsalata ◽  
Antonella Orlando ◽  
Benedetta D’Attoma ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Barrier Function ◽  
Rating Scale ◽  
Psychological Symptoms ◽  
Intestinal Barrier ◽  
Intestinal Barrier Function ◽  
Fatty Acid Binding ◽  
Gastrointestinal Symptom Rating Scale ◽  
Gi Symptoms ◽  
Irritable Bowel

Abstract Background Irritable bowel syndrome (IBS) is characterised by gastrointestinal (GI) and psychological symptoms (e.g., depression, anxiety, and somatization). Depression and anxiety, but not somatization, have already been associated with altered intestinal barrier function, increased LPS, and dysbiosis. The study aimed to investigate the possible link between somatization and intestinal barrier in IBS with diarrhoea (IBS-D) patients. Methods Forty-seven IBS-D patients were classified as having low somatization (LS = 19) or high somatization (HS = 28) according to the Symptom Checklist-90-Revised (SCL-90-R), (cut-off score = 63). The IBS Severity Scoring System (IBS-SSS) and the Gastrointestinal Symptom Rating Scale (GSRS) questionnaires were administered to evaluate GI symptoms. The intestinal barrier function was studied by the lactulose/mannitol absorption test, faecal and serum zonulin, serum intestinal fatty-acid binding protein, and diamine oxidase. Inflammation was assessed by assaying serum Interleukins (IL-6, IL-8, IL-10), and tumour necrosis factor-α. Dysbiosis was assessed by the urinary concentrations of indole and skatole and serum lipopolysaccharide (LPS). All data were analysed using a non-parametric test. Results The GI symptoms profiles were significantly more severe, both as a single symptom and as clusters of IBS-SSS and GSRS, in HS than LS patients. This finding was associated with impaired small intestinal permeability and increased faecal zonulin levels. Besides, HS patients showed significantly higher IL-8 and lowered IL-10 concentrations than LS patients. Lastly, circulating LPS levels and the urinary concentrations of indole were higher in HS than LS ones, suggesting a more pronounced imbalance of the small intestine in the former patients. Conclusions IBS is a multifactorial disorder needing complete clinical, psychological, and biochemical evaluations. Trial registration: https://clinicaltrials.gov/ct2/show/NCT03423069.

scholarly journals The Effect of Complex Korean Medical Treatment with Acupotomy on Irritable Bowel Syndrome: A Case Report

2020 ◽  
Vol 37 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Baek Ki Min ◽  
Joon Soo Jin ◽  
Do Eun Lee ◽  
Won Bin Shin ◽  
Jin Hyeon Shin ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Medical Center ◽  
Korean Medicine ◽  
National Medical ◽  
Gastrointestinal Symptom Rating Scale ◽  
Hospitalization Period ◽  
Irritable Bowel

The effects of complex Korean medicine treatment including acupotomy, on irritable bowel syndrome (IBS) are reported in this case study. A 54-year-old woman with diarrheal symptoms that alternatively improved and worsened for many years and worsening abdominal pain visited the emergency room and was diagnosed with IBS; she was admitted for approximately 2 weeks at the Acupuncture and Moxibustion Department of National Medical Center (NMC). Numerical rating scale (NRS), irritable bowel syndrome?quality of life (IBS-QOL), and gastrointestinal symptom rating scale (GSRS) scores were evaluated on the day of hospitalization, midway through the hospitalization period, and on the day of discharge. Abdominal pain was measured daily using NRS, and the score decreased from 8 at admission to 0 at discharge. The IBS-QOL percentile score improved from 42 points to 100 points. The total GSRS score also improved, from 30 points to 2 points. These results suggest that complex Korean medicine treatment with acupotomy, is useful for treating internal diseases, such as IBS, as well as musculoskeletal disorders.

scholarly journals SEVERITY OF IRRITABLE BOWEL SYNDROME SYMPTOMS AND FODMAPS INTAKE IN UNIVERSITY STUDENTS

2021 ◽  
Vol 58 (4) ◽  
pp. 461-467
Author(s):  
Mariana Cerne AUFIERI ◽  
Juliana Masami MORIMOTO ◽  
Renata Furlan VIEBIG
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
University Students ◽  
Rating Scale ◽  
Adult Population ◽  
Gastrointestinal Symptoms ◽  
Severe Abdominal Pain ◽  
Learning Ability ◽  
Gastrointestinal Symptom Rating Scale ◽  
Irritable Bowel

ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) symptoms such as diarrhea, bloating and abdominal pain can reduce University student’s productivity and learning ability. One of the possible treatments for IBS is the temporarily exclusion of foods that have a high content of short-chain fermentable carbohydrates, the fermentable, oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). OBJECTIVE: This study aimed to assess University student’s intake of foods that are rich in FODMAPs, looking for possible associations with the severity of IBS symptoms. METHODS: A cross-sectional study was carried out, with undergraduate students from a private University in the city of São Paulo, Brazil, aged between 19 and 46 years old and that were enrolled in different courses and stages. Students were invited to participate and those who gave their formal consent were included in this research. A sociodemographic and lifestyle questionnaire was applied, in addition to the Gastrointestinal Symptom Rating Scale - GSRS. Students also responded a short Food Frequency Questionnaire, developed to investigate habitual FODMAPs intake of Brazilian adult population. Spearman’s correlation analysis between the student’s GSRS scores and the frequency of foods rich in FODMAPs intake were performed in SPSS v.21. RESULTS: Fifty-six students were interviewed, with mean age of 21.4 years old (SD=4.41), with a predominance of women (76.8%). The GSRS results showed that 58.9% of students felt minimal to moderate abdominal discomfort and 14.3% had moderately severe to very severe abdominal pain during the prior week to the interview. Besides abdominal pain, the gastrointestinal symptoms that were most reported by students were flatulence (98.2%), stomach rumbling (89.3%) and eructations (85.7%). Greater symptom severity was observed in women (P=0.004) and sedentary students (P=0.003). Regarding FODMAPs consumption, honey (P=0.04), chocolate (P=0.03) and milk table cream (P=0.001) intakes were positively correlated with the greater severity of symptoms. CONCLUSION: Although clinical diagnosis is necessary to establish IBS, 73.2% of the students presented minimal to very severe abdominal pain during the prior week. Female had sedentary students had greater severity of gastrointestinal symptoms. A low FODMAP diet, well oriented, could bring some symptoms relief to these University students.

scholarly journals Return on investment of internet delivered exposure therapy for irritable bowel syndrome: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hugo Wallén ◽  
Perjohan Lindfors ◽  
Erik Andersson ◽  
Erik Hedman-Lagerlöf ◽  
Hugo Hesser ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Cost Effectiveness ◽  
Return On Investment ◽  
Rating Scale ◽  
Controlled Trial ◽  
Consort Statement ◽  
Economic Effects ◽  
Cognitive Behavior ◽  
Gastrointestinal Symptom Rating Scale ◽  
Irritable Bowel

Abstract Background Irritable bowel syndrome (IBS) is a debilitating and costly disorder. Cognitive behavior therapy (CBT) is effective in the treatment of IBS, both when delivered over the internet and in face-to-face settings. CBT consists of different components and little is known about their relative importance. We have in an earlier study showed that inclusion of exposure in the CBT for IBS makes it even more effective. In the present study we wanted to evaluate the economic effects for society of inclusion vs exclusion of exposure in an internet delivered CBT for IBS. Methods We used data from a previous study with 309 participants with IBS. Participants were randomized to internet delivered CBT with (ICBT) or without exposure (ICBT-WE). We compared direct and indirect costs at baseline, after treatment, and 6 months after treatment (primary endpoint; 6MFU). Data was also collected on symptom severity and time spent by therapists and participants. The relative Incremental Cost Effectiveness Ratio (ICER) was calculated for the two treatment conditions and the return on investment (ROI). Results Results showed that ICBT cost $213.5 (20%) more than ICBT-WE per participant. However, ICBT was associated with larger reductions regarding both costs and symptoms than ICBT-WE at 6MFU. The ICER was − 301.69, meaning that for every point improvement on the Gastrointestinal Symptom Rating Scale—IBS version in ICBT, societal costs would be reduced with approximately $300. At a willingness to pay for a case of clinically significant improvement in IBS symptoms of $0, there was an 84% probability of cost-effectiveness. ROI analysis showed that for every $1 invested in ICBT rather than ICBT-WE, the return would be $5.64 six months after treatment. Analyses of post-treatment data showed a similar pattern although cost-savings were smaller. Conclusions Including exposure in Cognitive Behavior Treatment for IBS is more cost-effective from a societal perspective than not including it, even though it may demand more therapist and patient time in the short term. Trial registration This study is reported in accordance with the CONSORT statement for non-pharmacological trials [1]. Clinicaltrials.gov registration ID: NCT01529567 (14/02/2013).

scholarly journals Irritable bowel syndrome-like symptoms in treated microscopic colitis patients compared with controls: a cross-sectional study

2019 ◽  
Vol 8 (5) ◽  
pp. 374-380
Author(s):  
Jenny Pagoldh ◽  
David Lundgren ◽  
Ole B Suhr ◽  
Pontus Karling
Keyword(s):  
Irritable Bowel Syndrome ◽  
Rating Scale ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Microscopic Colitis ◽  
Faecal Calprotectin ◽  
Cross Sectional ◽  
Control Subjects ◽  
Gastrointestinal Symptom Rating Scale ◽  
Irritable Bowel

Abstract Background The prevalence of irritable bowel syndrome (IBS)-like symptoms is high in untreated patients with microscopic colitis (MC), but there is uncertainty of the prevalence of IBS-like symptoms in treated patients. We assessed the degree of IBS-like symptoms in patients with MC in comparison to control subjects, and investigated the association between IBS-like symptoms and faecal calprotectin (FC) in MC patients. Methods Patients with an established MC diagnosis (n = 57) were compared to sex- and age-matched controls (n = 138) for scores in the GSRS-IBS (Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome) and HADS (Hospital Anxiety Depression Scale). In MC patients, an FC level was simultaneously analysed. Results The median interval from MC diagnoses to the time the subjects participated in the study was 5.5 years (25th–75th percentiles; 4.5–9.5 years). The total GSRS-IBS score, subscores for abdominal pain, bloating, and diarrhoea were significantly higher in MC patients compared to controls (all P < 0.001). There was a significant correlation between FC levels and reported bowel frequency (P = 0.023), but there was no correlation between FC levels and GSRS-IBS scores. Patients with MC had significantly higher scores on anxiety (HADS-A) (P < 0.001) and used more selective serotonin-reuptake-inhibitor drugs (P = 0.016) than the control subjects. However, only the control subjects (not the patients with MC) showed significant correlations between GSRS-IBS scores and HADS scores. Conclusions Patients with MC reported more IBS-like symptoms and anxiety than control subjects but neither FC levels nor symptoms of affectivity were significantly correlated with IBS-like symptoms.

scholarly journals The role of visceral hypersensitivity in the pathogenesis of irritable bowel syndrome

2021 ◽  
Vol 93 (8) ◽  
pp. 969-974
Author(s):  
Alina A. Makarova ◽  
Irina N. Ruchkina ◽  
Asfold I. Parfenov ◽  
Lilia K. Indeykina ◽  
Natalia V. Romashkina
Keyword(s):  
Irritable Bowel Syndrome ◽  
Drug Therapy ◽  
Research Methods ◽  
Balloon Dilation ◽  
Visceral Hypersensitivity ◽  
Visceral Sensitivity ◽  
Etiological Factors ◽  
Irritable Bowel

This research includes visceral sensitivity and its mechanisms involved in the development of irritable bowel syndrome. Visceral hypersensitivity occupies the key place. The research has the description of etiological factors that form visceral hypersensitivity and also visceral sensitivity instrumental research methods, based on the use of the balloon dilation. The research also has the schemes of drug therapy for irritable bowel syndrome meanwhile the special attention is paid to the possible use of the sorbed probiotics and psychopharmacological drugs.

Efficacy of Kolofort for the treatment of patients with irritable bowel syndrome

2016 ◽  
Vol 88 (8) ◽  
pp. 40-45 ◽  
Author(s):  
V V Tsukanov ◽  
O S Rzhavicheva ◽  
A V Vasjutin ◽  
O V Dunaevskaja ◽  
Ju L Tonkih ◽  
...  
Keyword(s):  
Nervous System ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Pain Syndrome ◽  
Sensitivity Index ◽  
Visceral Sensitivity ◽  
Tnf Α ◽  
Stool Form ◽  
Defecation Disorders ◽  
Irritable Bowel

Aim. To determine the efficacy and safety of Kolofort in the treatment of patients with irritable bowel syndrome (IBS). Subjects and methods. 52 patients (16 men and 36 women) aged 26 to 59 years were examined over 4 months to rule out organic disease. The diagnosis of IBS was established on the basis of the Rome III diagnostic criteria (2006). Seven patients were diagnosed as having IBS with a preponderance of constipation; 3 had IBS with a preponderance of diarrhea, and 42 had mixed IBS. Thereafter they were given Kolofort, a combination release-active antibody drug having anxiolytic, anti-inflammatory, and spasmolytic effects. Kolofort affects the ligand-receptor interactions of the brain-specific protein S-100 with serotonin receptors and σ1-receptors in the central nervous system and that of histamine with histamine H4 receptors in the gastrointestinal tract and modifies (regulates) the functional activity of tumor necrosis factor-α (TNF-α). The regulatory action of the drug at the level of the central and autonomic nervous system and the immune system manifests itself as spasmolytic, anti-inflammatory, and sedative effects, which as a whole effectively normalizes gastrointestinal motility. For 3 months, the patients took sublingual Kolofort in a dose of 2 tablets thrice daily for 2 weeks, then 2 tablets twice daily for 2.5 months. Control was made 2 weeks, 1, 2, and 3 months after treatment initiation. The investigators assessed abdominal pain syndrome, defecation disorders, abdominal distension, and flatulence by the visual analogue scale (VAS-IBS questionnaire), visceral sensitivity index (VSI questionnaire), quality of life (QL) in patients with IBS (IBS-QoL questionnaire), and stool form according to the Bristol Stool Chart and measured the levels of TNF-α and interleukin (IL)-1β and IL-10 before and after treatment. Results. The efficacy of Kolofort showed itself within 2 weeks of its administration against all the study functional parameters (pain, defecation disorder, and flatulence). After one month of therapy, the efficacy of Kolofort achieved meaningful statistical significance against abdominal pain, complaints of flatulence, visceral sensitivity index, and QL. The statistically significant restoration of a stool form was achieved 2 months after treatment and 3-month Kolofort treatment showed a clear-cut positive clinical effect that appeared as reductions in pain syndrome (214±0.22; р < 0.001) and visceral hypersensitivity symptoms (from 30.33±2.9 to 67.76±6.5; р < 0.001), improvements in subjective sensations associated with defecation disorders (from 6.95±0.71 to 2.74±0.28; р < 0.001), stool form, and QL indicators (from 103.48±9.06 to 44.95±5.4; р < 0.001), and a decrease in blood TNF-α levels after treatment termination (from 9.16 to 7.02 pg/ml; р < 0.026). A Kolofort treatment cycle for IBS produced no clinically relevant side effects. Conclusion. Kolofort was highly effective in relieving symptoms, in normalizing the psychological status, and in lowering the levels of TNF-α in the treatment of IBS. The efficacy of the drug was achieved because of its combined effect on the main components of the pathogenesis of IBS.

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