Irritable bowel syndrome – psychiatric issues

Abstract Introduction: Irritable bowel syndrome is a chronic gastrointestinal disease classified as a functional gastrointestinal disorder. It has been diagnosed on the basis of the so-called Rome IV criteria since 2016. The prevalence of IBS in the general population is about 10–20%, with most patients being women. The etiology of the syndrome is multifactorial and is associated with visceral sensory dysfunction, abnormalities of motor and secretory bowel function, a history of infectious diarrhea and abnormalities in gut microbiota, dysregulation of the brain–gut axis (the influence of the hypothalamic-pituitary-adrenal axis and sex hormones), genetic, psychosocial, and environmental factors, and the patient's personality traits. IBS patients may show differences in the structure and function of the brain when compared to healthy control individuals. Treatment of IBS involves the use of non-pharmacological interventions (psychotherapy, education, hypnotherapy, dietary modifications, regular physical activity) and pharmacotherapy (cholinolytic drugs, opioid receptor antagonists, tricyclic antidepressants, serotonin 5-HT3 receptor antagonists and 5-HT4 agonists). Aim: The aim of the authors of this work is to draw attention to certain psychiatric aspects of the irritable bowel syndrome. It meets the criteria for a somatization disorder. Somatization is an important psychological factor directly related to the severity of IBS. It is estimated that the prevalence of psychiatric disorders among IBS patients ranges from 40% to 90% and is higher than in the general population. Affective disorders and anxiety disorders are the most commonly diagnosed. Method: The article reviews the research and works available in the Google Scholar and PubMed databases combining the issue of IBS with psychiatric aspects, i.e. common for IBS and psychiatric disorders, etiopathogenesis, the concept of somatization in the context of IBS, and the coexistence of diseases and mental disorders with the irritable bowel syndrome. Conclusion: Further research is needed to determine the causes of comorbidity of IBS and mental disorders.

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The Association of Irritable Bowel Syndrome and Somatization Disorder

Annals of Clinical Psychiatry ◽

10.3109/10401230109147126 ◽

2001 ◽

Vol 13 (1) ◽

pp. 25-30 ◽

Cited By ~ 57

Author(s):

Anthony Miller ◽

Carol North ◽

Ray Clouse ◽

Richard Wetzel ◽

Edward Spitznagel ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Somatization Disorder ◽

Irritable Bowel

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Identification of potential biomarkers for abdominal pain in IBS patients by bioinformatics approach

BMC Gastroenterology ◽

10.1186/s12876-021-01626-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zhongyuan Lin ◽

Yimin Wang ◽

Shiqing Lin ◽

Decheng Liu ◽

Guohui Mo ◽

...

Keyword(s):

Gene Expression ◽

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Gastrointestinal Disease ◽

Rectal Mucosa ◽

Interaction Network ◽

Enrichment Analysis ◽

Functional Enrichment ◽

Irritable Bowel ◽

Potential Biomarkers

Abstract Background Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disease characterized by chronic abdominal discomfort and pain. The mechanisms of abdominal pain, as a relevant symptom, in IBS are still unclear. We aimed to explore the key genes and neurobiological changes specially involved in abdominal pain in IBS. Methods Gene expression data (GSE36701) was downloaded from Gene Expression Omnibus database. Fifty-three rectal mucosa samples from 27 irritable bowel syndrome with diarrhea (IBS-D) patients and 40 samples from 21 healthy volunteers as controls were included. Differentially expressed genes (DEGs) between two groups were identified using the GEO2R online tool. Functional enrichment analysis of DEGs was performed on the DAVID database. Then a protein–protein interaction network was constructed and visualized using STRING database and Cytoscape. Results The microarray analysis demonstrated a subset of genes (CCKBR, CCL13, ACPP, BDKRB2, GRPR, SLC1A2, NPFF, P2RX4, TRPA1, CCKBR, TLX2, MRGPRX3, PAX2, CXCR1) specially involved in pain transmission. Among these genes, we identified GRPR, NPFF and TRPA1 genes as potential biomarkers for irritating abdominal pain of IBS patients. Conclusions Overexpression of certain pain-related genes (GRPR, NPFF and TRPA1) may contribute to chronic visceral hypersensitivity, therefore be partly responsible for recurrent abdominal pain or discomfort in IBS patients. Several synapses modification and biological process of psychological distress may be risk factors of IBS.

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The Intestinal Gas Questionnaire (IGQ): Psychometric validation of a new instrument for measuring gas‐related symptoms and their impact on daily life among general population and irritable bowel syndrome

Neurogastroenterology & Motility ◽

10.1111/nmo.14202 ◽

2021 ◽

Author(s):

Martin Duracinsky ◽

Sharon Archbold ◽

Beatriz Lobo ◽

Pascal Bessonneau ◽

Frédérique Thonon ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

General Population ◽

Daily Life ◽

Psychometric Validation ◽

Intestinal Gas ◽

New Instrument ◽

Irritable Bowel

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Risks of Major Mental Disorders and Irritable Bowel Syndrome among the Offspring of Parents with Irritable Bowel Syndrome: A Nationwide Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094679 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4679

Author(s):

Ta-Chuan Yeh ◽

Ya-Mei Bai ◽

Shih-Jen Tsai ◽

Tzeng-Ji Chen ◽

Chih-Sung Liang ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Mental Disorders ◽

Autism Spectrum ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Logistic Regression Models ◽

Early Implementation ◽

Increased Risk ◽

Nationally Representative ◽

Irritable Bowel

Irritable bowel syndrome (IBS) is a functional bowel disorder that is highly comorbid with mental disorders. However, few studies have examined the risk of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder, major depressive disorder (MDD), and schizophrenia in the offspring of parents with IBS. We used nationally representative cross-sectional survey data to analyze cross-generational transmission patterns of both IBS and major mental disorders. Odds ratio (OR) was calculated by using logistic regression models with adjustment for potential confounding factors. Offspring of parents with IBS were more likely to develop IBS themselves (OR = 2.41, 95% confidence interval (CI), 2.09–2.78), ADHD (OR = 1.33, 95% CI, 1.08–1.62), and MDD (OR = 1.32, 95% CI, 1.04–1.68) than the controls. Data stratification by parental sex revealed that paternal IBS increased risk of ADHD (OR = 1.34, 95% CI, 1.01–1.77) in the offspring, while maternal IBS increased the risk of MDD (OR = 1.51, 95% CI, 1.11–2.06). This is the first study to reveal parental IBS is associated with IBS, ADHD, and MDD among offspring, suggesting the necessity for early implementation of prevention strategies for at-risk children.

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Irritable bowel syndrome and the brain-gut connection

A Comprehensive Overview of Irritable Bowel Syndrome ◽

10.1016/b978-0-12-821324-7.00003-4 ◽

2020 ◽

pp. 27-42

Author(s):

Leon Pawlik ◽

Aleksandra Tarasiuk

Keyword(s):

Irritable Bowel Syndrome ◽

Irritable Bowel ◽

The Brain

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PSYCHOLOGICAL FEATURES OF CHILDREN WITH IRRITABLE BOWEL SYNDROME

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.20.1.91 ◽

2020 ◽

Vol 20 (1) ◽

pp. 91-95

Author(s):

A.V. Zubarenko ◽

V.V. Luzan ◽

T.Yu. Kravchenko ◽

G.K. Kopiyka ◽

V.I. Martyuk

Keyword(s):

Irritable Bowel Syndrome ◽

Emotional Disorders ◽

Functional Gastrointestinal Disorders ◽

Psychological Disorders ◽

Gastrointestinal Disorders ◽

Depressed Type ◽

Clinical Variant ◽

Irritable Bowel ◽

Psychological Features ◽

The Brain

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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Su1200 Prevalence of Diverticular Disease in the General Population, and Link to Diarrhea but Not Constipation or the Irritable Bowel Syndrome

Gastroenterology ◽

10.1016/s0016-5085(12)61693-x ◽

2012 ◽

Vol 142 (5) ◽

pp. S-449

Author(s):

Jeong-Yeop Song ◽

Peter T. Schmit ◽

Lars Agreus ◽

Lars Kjellström ◽

Henry Nyhlin ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

General Population ◽

Diverticular Disease ◽

Irritable Bowel

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Recognizing the Co-occurrence of Chronic Pain and Mental Illness

Overlapping Pain and Psychiatric Syndromes ◽

10.1093/med/9780190248253.003.0002 ◽

2020 ◽

pp. 16-26

Author(s):

Jan Jaracz

Keyword(s):

Chronic Pain ◽

General Population ◽

Anxiety Disorders ◽

Psychiatric Disorders ◽

Epidemiological Data ◽

Convincing Evidence ◽

Medical Problems ◽

Close Relationship ◽

Negative Effect ◽

Irritable Bowel

Epidemiological data regarding chronic pain and psychiatric disorders are reviewed. Particular attention is given to the interplay between pain and depressive and anxiety disorders. In the general population, 19 to 33% of responders report chronic pain, with higher rates in elderly people. Major depression is one of the most common medical problems, affecting nearly 6% of the population, with a lifetime prevalence of 11 to 14%. The presence of depression in persons with chronic pain is significantly higher (21%) than that in the general population, and this proportion is even higher (52–85%) in specific populations of patients attending specialist clinics. Conversely, convincing evidence published in numerous studies has documented that at least 50% of depressed patients report painful symptoms. Pain exerts a negative effect on treatment and a poorer outcome in multiple domains of quality of life. Moreover, pain increases the economic burden resulting from depression. A close relationship between pain and depression has been established in the functional somatic syndromes of fibromyalgia and irritable bowel syndrome. An association between anxiety disorders and pain has also been documented. Epidemiological studies have provided evidence suggesting the common co-occurrence of pain and selected psychiatric disorders. This is an indication for practitioners to examine patients with pain for symptoms of depression and anxiety disorders and conversely to interview patients with psychiatric disorders in regard to the presence or absence of pain. These studies also provide the inspiration for further investigations of the intriguing shared biological basis or pain and psychiatric disorders.

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