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Al-Beltagi M, Saeed NK, Bediwy AS, Elbeltagi R. Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders. World J Clin Pediatr 2025; 14. [DOI: 10.5409/wjcp.v14.i2.103323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 12/14/2024] [Accepted: 01/02/2025] [Indexed: 03/18/2025] Open
Abstract
BACKGROUND
Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.
AIM
To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.
METHODS
A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.
RESULTS
The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.
CONCLUSION
Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Paediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Nermin K Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Governmental Hospitals, Manama 26671, Bahrain
- Medical Microbiology Section, Department of Pathology, The Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel S Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
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Hasan ABMN, Asaduzzaman M, Mahfuj MN, Islam R, Bhuyan MMK, Basak P, Sharif AB. Prevalence of irritable bowel syndrome and its association to mental health among the private university students of Dhaka, Bangladesh. PLOS GLOBAL PUBLIC HEALTH 2025; 5:e0004670. [PMID: 40402939 PMCID: PMC12097621 DOI: 10.1371/journal.pgph.0004670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Accepted: 04/28/2025] [Indexed: 05/24/2025]
Abstract
Irritable Bowel Syndrome is a common gastrointestinal disorder linked to psychological distress and lifestyle factors. In Bangladesh, young adults may experience exacerbated IBS symptoms due to particular hardships. This study aims to evaluate the prevalence of IBS and its association with mental health status among private university students. A cross-sectional study conducted between November 2023 and May 2024 and involved 550 students aged 19-40 years from three private universities in Dhaka, Bangladesh selected through convenience sampling. Data were collected via in-person interviews using a semi-structured questionnaire that included the Rome III and the DASS-21 scale. Pearson's χ² test was used to explore associations and multiple logistic regression was employed to identify factors influencing IBS. The prevalence of IBS among the students was 31.63%. Female students had higher odds of developing IBS compared to males (AOR = 1.71, 95% CI: 1.19 to 3.36). Psychological distress was strongly associated with IBS, with students experiencing severe anxiety (AOR = 3.14, 95% CI: 1.11 to 7.24) and stress (AOR = 3.39, 95% CI: 1.16 to 6.79) showing increased odds of IBS. Additionally, satisfaction with academic major (AOR = 0.46, 95% CI: 0.18 to 0.96) indicates 54% lower odds of IBS compared to those who were unsatisfied. Physical activity (AOR = 0.64, 95% CI: 0.29 to 0.90) shows a 36% reduction in the odss of IBS with moderate physical activity (20-60 minutes per day). Daily vegetable consumption (AOR = 0.81, 95% CI: 0.67 to 0.89) suggested a 19% lower odds of IBS. Malnutrition (AOR = 1.77, 95% CI: 1.11 to 2.82) was associated with a 77% increased odds of IBS. The findings emphasize the importance of implementing comprehensive campuswide health promotion programs that address psychological distress, promote healthy lifestyle choices, and provide nutritional guidance to alleviate the burden of IBS among them.
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Affiliation(s)
- A. B. M. Nahid Hasan
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Promotion and Development Society (PPDS), Dhaka, Bangladesh
- Department of Public Health Nutrition, Primeasia University, Dhaka, Bangladesh
| | - Md. Asaduzzaman
- Department of Public Health, North South University, Dhaka, Bangladesh
- Bangladesh Red Crescent Society, Dhaka, Bangladesh
| | | | - Rashedul Islam
- Department of Philosophy and Social-Political Science, Alexandru Ioan Cuza University of Iasi, Iasi, Romania
- Department of Clinical-Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Md. Mohasin Kabir Bhuyan
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Foundation, Dhaka, Bangladesh
| | - Prosenjit Basak
- Department of Public Health Nutrition, Primeasia University, Dhaka, Bangladesh
- Department of Public Health, University of South Asia, Dhaka, Bangladesh
| | - Azaz Bin Sharif
- Department of Public Health, North South University, Dhaka, Bangladesh
- Global Health Institute, North South University, Dhaka, Bangladesh
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Farzanegan M, Azizi A, Fard SS, Sadeghi A, Arefi M, Badi HS, Adibi P, Daghaghzadeh H, Zanjani HA. Effectiveness of a bioenergy economy program versus mindfulness-based cognitive therapy on the severity and psychological symptoms of irritable bowel syndrome. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2025; 14:107. [PMID: 40271268 PMCID: PMC12017422 DOI: 10.4103/jehp.jehp_1924_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/20/2024] [Indexed: 04/25/2025]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder causing a great burden on patients' lives due to its physical and psychological symptoms. Mindfulness-based cognitive therapy (MBCT) has previously alleviated IBS symptoms. Bioenergy economy (BEE) is a novel mind-body intervention that has shown moderating effects on many psychological and physical symptoms, particularly in chronic diseases. This research aimed to compare the effectiveness of MBCT and BEE on IBS symptom severity, somatic symptoms, depression, and anxiety. MATERIALS AND METHODS This study was conducted using a quasi-experimental method with a pre-test, post-test, and follow-up design with a control group in Isfahan, Iran. Forty-five patients with IBS were divided into two experimental and one control group (15 subjects in each group). The patients were assessed using the ROME III Diagnostic Criteria for IBS, IBS Severity Index (IBS-SI), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory, and Patient Health Questionnaire (PHQ-15) before and after the intervention. Data were analyzed using analysis of covariance, and SPSS-22 software was used. RESULTS The findings showed that MBCT and BEE both had significant effects on the IBS symptom severity, somatic symptoms, depression, and anxiety (P < 0.01), but there was no significant difference between the mean scores of the two experimental groups in any of the post-test or the follow-up stages (P > 0.05). This concludes that there was no difference between the effectiveness of MBCT and BEE programs (P > 0.05). CONCLUSION Although both interventions had significant results in improving patients' symptoms, the BEE program had a stronger and wider range of effectiveness.
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Affiliation(s)
- Mahboubeh Farzanegan
- Department of Bioenergy and Psychosomatic Health, Energy Medicine University, California, USA
- Department of Psychosomatic Research, Danesh-e Tandorosti Institute, Isfahan, Iran
| | - Ali Azizi
- Department of Psychosomatic Research, Danesh-e Tandorosti Institute, Isfahan, Iran
| | - Shahla Safavi Fard
- Department of Psychology, Islamic Azad University of Khorasgan, Isfahan, Iran
| | - Ali Sadeghi
- Department of Psychosomatic Research, Danesh-e Tandorosti Institute, Isfahan, Iran
| | - Mozhgan Arefi
- Department of Psychology, Islamic Azad University of Khorasgan, Isfahan, Iran
| | - Hasan Shahoon Badi
- Gastroenterology and Liver Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Gastroenterology and Liver Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Daghaghzadeh
- Gastroenterology and Liver Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
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Asal MGR, El-Sayed AAI, Alsenany SA, Ramzy ZH, Dawood RFA. Self-administered active versus sham acupressure for diarrhea predominant irritable bowel syndrome: a nurse-led randomized clinical trial. BMC Nurs 2025; 24:106. [PMID: 39875940 PMCID: PMC11776273 DOI: 10.1186/s12912-024-02594-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 12/09/2024] [Indexed: 01/30/2025] Open
Abstract
BACKGROUND Diarrhea-predominant irritable bowel syndrome (IBS-D) significantly impacts patients' quality of life, with existing treatments offering limited relief. Self-administered acupressure presents a potential non-invasive, cost-effective treatment option that could alleviate symptoms and enhance health outcomes in these patients. AIM This randomized controlled trial aimed to evaluate the effect of active acupressure compared to sham acupressure on primary and secondary outcomes among IBS-D patients. METHOD The study included 63 patients with IBS-D, recruited from Alexandria Main University Hospital, Egypt. Participants were randomized into either an active acupressure group or a sham acupressure group. Both groups underwent two days of training, followed by four weeks of intervention. The active group applied pressure to specific therapeutic acupoints, while the sham group used non-therapeutic points. Outcomes were assessed at baseline, week 2, and week 4. RESULTS The active acupressure group showed a significant reduction in symptom severity, improved stool consistency, and frequency, and greater adequate symptom relief by week 4 compared to the sham group. Psychological outcomes, including anxiety and depression, also improved significantly in the active group. Additionally, the active group reported reduced use of rescue medications. CONCLUSION Active acupressure is an effective nursing intervention for alleviating symptoms of IBS-D, particularly when applied consistently over time. It improves both physical and psychological outcomes, offering a valuable non-pharmacological treatment option. IMPLICATIONS Nurses can integrate self-administered acupressure into IBS-D care plans, teaching patients this technique to manage symptoms independently, thus enhancing their quality of life (QOL) and reducing reliance on conventional medications. This intervention aligns with holistic nursing care and offers a cost-effective, patient-friendly solution for managing IBS-D. TRIAL REGISTRATION This study was prospectively registered as a randomized controlled trial in https://clinicaltrials.gov/ Registration Date: January 7, 2023, Registration Number: NCT05702255.
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Affiliation(s)
- Maha Gamal Ramadan Asal
- Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | | | - Samira Ahmed Alsenany
- Public Health Department, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zahraa Hassan Ramzy
- Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Rasha Fathy Ahmed Dawood
- Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Devi D, Bhattacharya S, Tiwari S, Tripathi A, Singh K, Rungta S. Exploring the Impact of Yoga Intervention on Psychological Symptoms in Irritable Bowel Syndrome Patients: A Randomized Controlled Study. Int J Yoga 2025; 18:58-66. [PMID: 40365365 PMCID: PMC12068461 DOI: 10.4103/ijoy.ijoy_200_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 11/09/2024] [Accepted: 11/14/2024] [Indexed: 05/15/2025] Open
Abstract
Background Irritable bowel syndrome (IBS) is an extremely prevalent gastrointestinal disorder that has an unfavorable impact on the living standard and IBS-related multiple symptoms. 11%-15% of people worldwide are suffering from IBS. Secondary symptoms such as depression or anxiety are experienced by IBS patients. Yoga practices combined with traditional medical treatment can be a successful therapy for IBS. Objectives The objective of this randomized control research was to observe the effectiveness of the yoga intervention as an add-on therapy in IBS patients with conventional treatment and its comparison with IBS with conventional treatment as a control. Materials and Methods The suggested research is an open-blinded, prospective, randomly assigned, single-center, parallel-group, and end-point trial. Patients with IBS who satisfied the Rome Ⅳ criteria for diagnosis were recruited and randomly allocated into two groups: Intervention Group A (Yoga + conventional treatment) and Control Group B (Conventional treatment only). Group A (n = 85) received yoga intervention five times a week for 3 months, and Group B (n = 80) took their prescribed medication without yoga intervention. Psychological symptoms and IBS severity scores before and after yoga intervention were measured and compared with the control group with the help of validated questionnaires: Depression, Anxiety, and Stress Score (DASS-21) and IBS Severity Score, respectively. Results The body weight and body mass index after 3 months of follow-up were significantly lowered (P < 0.05) in the yoga intervention group as compared to the control group. The overall severity of IBS after yoga interventions in Group A (259.2 ± 49.9-256.1 ± 48.6, P < 0.01) was significantly reduced than the control group (270 ± 56.6-271.9 ± 54.8, P > 0.05). Moreover, the psychological stress (P < 0.05) and anxiety (P < 0.01) scores were also significantly decreased after 3 months of follow-up in the yoga intervention group. The serum cortisol level was decreased in Group A. However, it could not reach a significant level. Conclusion The current study indicates an affirmative result of yoga intervention along with conventional treatment for patients with IBS might be strongly advised.
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Affiliation(s)
- Diksha Devi
- Department of Physiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sandeep Bhattacharya
- Department of Physiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sunita Tiwari
- Department of Physiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Adarsh Tripathi
- Department of Psychiatry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Kalpana Singh
- Department of Biochemistry, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sumit Rungta
- Department of Gastroenterology, King George’s Medical University, Lucknow, Uttar Pradesh, India
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Borghini R, Spagnuolo A, Donato G, Borghini G. Gluten-Free Diet for Fashion or Necessity? Review with New Speculations on Irritable Bowel Syndrome-like Disorders. Nutrients 2024; 16:4236. [PMID: 39683629 DOI: 10.3390/nu16234236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 11/27/2024] [Accepted: 12/05/2024] [Indexed: 12/18/2024] Open
Abstract
Nowadays, the gluten-free diet (GFD) has become much more than the dietary treatment for celiac disease. Due to its presumed beneficial effects even in non-celiac subjects, it has become a new fashion statement and it is promoted by some healthcare professionals, social media and marketing strategists. On the other hand, regardless of a proper medical indication, a GFD may present side effects, such as poor palatability, high costs and socio-psychological adversities. Moreover, it can be an obstacle to correct clinical practice and may induce nutritional deficiency due to a low-quality diet. In addition, a GFD can trigger or exacerbate many irritable bowel syndrome (IBS)-like disorders in predisposed subjects: reactivity to dietary nickel, the increased consumption of FODMAP-rich foods and histamine intolerance seem to frequently play a relevant role. The possible intersections between high-risk foods in these categories of patients, as well as the possible overlaps among IBS-like disorders during GFD, are described. In conclusion, it is advisable to undergo a careful clinical evaluation by a gastroenterologist and a nutritionist (in some cases, also a psychotherapist) before starting and during a GFD, because both benefits and risks are possible. It is also important to take into account IBS-like disorders that can be exacerbated by a GFD and that are still underestimated today.
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Affiliation(s)
- Raffaele Borghini
- Stella Maris S.T.P.-Gastroenterology Unit, Via Giuseppe Prina, 8, 00139 Rome, Italy
| | - Alessia Spagnuolo
- Medical Oncology, Department of Radiology, Oncology and Pathology, Sapienza University of Rome, 00155 Rome, Italy
| | - Giuseppe Donato
- Gastroenterology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, 00155 Rome, Italy
| | - Giovanni Borghini
- Stella Maris S.T.P.-Food and Human Nutrition Unit, 00139 Rome, Italy
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Azarfarin M, Moradikor N, Matin S, Dadkhah M. Association Between Stress, Neuroinflammation, and Irritable Bowel Syndrome: The Positive Effects of Probiotic Therapy. Cell Biochem Funct 2024; 42:e70009. [PMID: 39487668 DOI: 10.1002/cbf.70009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 09/23/2024] [Accepted: 10/14/2024] [Indexed: 11/04/2024]
Abstract
Stress refers to an organism's response to environmental threats in normal condition to maintain homeostasis in the body. In addition, strong inflammatory reactions induced by the hypothalamic-pituitary-adrenal (HPA) axis under stress condition during a long time. Reciprocally, chronic stress can induce the irritable bowel syndrome (IBS) which is a well-known gut disorder thereby play an important role in the promotion and pathophysiology of neuropsychiatric diseases. It has been demonstrated that leaky gut is a hallmark of IBS, leads to the entrance the microbiota into the bloodstream and consequent low-grade systemic inflammation. In the current review, we will discuss the mechanisms by which stress can influence the risk and severity of IBS and its relationship with neuroinflammation. Also, the role of probiotics in IBS co-existing with chronic stress conditions is highlighted.
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Affiliation(s)
- Maryam Azarfarin
- Department of Neuroscience, Faculty of Advanced Medical, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrollah Moradikor
- International Center for Neuroscience Research, Institute for Intelligent Research, Tbilisi, Georgia
| | - Somaieh Matin
- Digestive Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Masoomeh Dadkhah
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Pharmaceutical Sciences Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
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Islam MM, Mahbub NU, Hong ST, Chung HJ. Gut bacteria: an etiological agent in human pathological conditions. Front Cell Infect Microbiol 2024; 14:1291148. [PMID: 39439902 PMCID: PMC11493637 DOI: 10.3389/fcimb.2024.1291148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 08/12/2024] [Indexed: 10/25/2024] Open
Abstract
Through complex interactions with the host's immune and physiological systems, gut bacteria play a critical role as etiological agents in a variety of human diseases, having an impact that extends beyond their mere presence and affects the onset, progression, and severity of the disease. Gaining a comprehensive understanding of these microbial interactions is crucial to improving our understanding of disease pathogenesis and creating tailored treatment methods. Correcting microbial imbalances may open new avenues for disease prevention and treatment approaches, according to preliminary data. The gut microbiota exerts an integral part in the pathogenesis of numerous health conditions, including metabolic, neurological, renal, cardiovascular, and gastrointestinal problems as well as COVID-19, according to recent studies. The crucial significance of the microbiome in disease pathogenesis is highlighted by this role, which is comparable to that of hereditary variables. This review investigates the etiological contributions of the gut microbiome to human diseases, its interactions with the host, and the development of prospective therapeutic approaches. To fully harness the benefits of gut microbiome dynamics for improving human health, future research should address existing methodological challenges and deepen our knowledge of microbial interactions.
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Affiliation(s)
- Md Minarul Islam
- Department of Biomedical Sciences and Institute for Medical Science, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Nasir Uddin Mahbub
- Department of Biomedical Sciences and Institute for Medical Science, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Seong-Tshool Hong
- Department of Biomedical Sciences and Institute for Medical Science, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Hea-Jong Chung
- Gwangju Center, Korea Basic Science Institute, Gwangju, Republic of Korea
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Ionescu VA, Gheorghe G, Georgescu TF, Bacalbasa N, Gheorghe F, Diaconu CC. The Latest Data Concerning the Etiology and Pathogenesis of Irritable Bowel Syndrome. J Clin Med 2024; 13:5124. [PMID: 39274340 PMCID: PMC11395839 DOI: 10.3390/jcm13175124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/16/2024] Open
Abstract
Globally, irritable bowel syndrome (IBS) is present in approximately 10% of the population. While this condition does not pose a risk of complications, it has a substantial impact on the patient's quality of life. Moreover, this disease has a significant financial impact on healthcare systems. This includes the direct costs associated with the diagnosis and treatment of these patients, as well as the indirect costs that arise from work absenteeism and reduced productivity. In light of these data, recent research has focused on elucidating the pathophysiological basis of this condition in order to improve the quality of life for affected individuals. Despite extensive research to date, we still do not fully understand the precise mechanisms underlying IBS. Numerous studies have demonstrated the involvement of the gut-brain axis, visceral hypersensitivity, gastrointestinal dysmotility, gut microbiota dysbiosis, food allergies and intolerances, low-grade mucosal inflammation, genetic factors, and psychosocial factors. The acquisition of new data is crucial for the advancement of optimal therapeutic approaches aimed at enhancing the general health of these patients while simultaneously reducing the financial burden associated with this ailment.
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Affiliation(s)
- Vlad Alexandru Ionescu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (T.F.G.)
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Gina Gheorghe
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (T.F.G.)
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Teodor Florin Georgescu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (T.F.G.)
- General Surgery Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
| | - Nicolae Bacalbasa
- Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, 022328 Bucharest, Romania;
| | | | - Camelia Cristina Diaconu
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania; (V.A.I.); (T.F.G.)
- Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 105402 Bucharest, Romania
- Academy of Romanian Scientists, 050085 Bucharest, Romania
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Donthu RK, Mohammed AS, Sasi Kiran NOA, Kancharlapalli PK, Pallem A. A cross-sectional study of stressful life events and quality of life among FGID and non-FGID patients. Ind Psychiatry J 2024; 33:S134-S141. [PMID: 39534115 PMCID: PMC11553618 DOI: 10.4103/ipj.ipj_341_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 11/16/2024] Open
Abstract
Background Gastrointestinal disorders, both non-functional and functional, are prevalent among the general population, and understanding these in relation to psychological factors is crucial for clinicians to design effective management strategies. Psycho-social factors, including stressful life events, significantly impact disease outcomes and quality of life (QOL). Limited research has explored these factors in the context of functional gastrointestinal disorders (FGIDs) and non-functional gastrointestinal disorders (non-FGIDs), especially in culturally diverse populations. Aim To investigate the relationship between QOL and stressful life events in patients with FGID and non-FGID. Materials and Methods This study involved 200 participants diagnosed with FGID using ROME IV criteria and non-FGID clinically. The research utilized a socio-demographic questionnaire, the Psychological General Well-Being Index (QOL), and the Presumptive Stressful Life Events Scale (PSLES). Results Among FGID patients, functional dyspepsia was the common diagnosis, while erosive gastritis was more prevalent among non-FGID patients. A significant association in QOL was observed between FGID and non-FGID (P < 0.001), with FGID patients exhibiting lower scores. Overall, a mild negative correlation was found between QOL and PSLES (r = -0.20, P = 0.003). Stressful life events contributed to 13% variance of QOL in non-FGID patients. Conclusion This study highlights the impact of stressful life events on QOL in both FGID and non-FGID patients. While FGID patients experienced poorer QOL, non-FGID also showed QOL reductions with recent life events. Understanding these associations can aid clinicians in comprehensive patient care, emphasizing the importance of addressing psycho-social factors alongside clinical symptoms. Cultural nuances influencing stress perception and its relation to gastrointestinal disorders merit further investigation.
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Affiliation(s)
- Raj Kiran Donthu
- Department of Psychiatry and Medical Gastroenterology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
| | - Abdul S. Mohammed
- Department of Psychiatry and Medical Gastroenterology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
| | - Nagula Omkar Ambika Sasi Kiran
- Department of Psychiatry and Medical Gastroenterology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
| | - Prasanna K. Kancharlapalli
- Department of Psychiatry and Medical Gastroenterology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
| | - Ahlada Pallem
- Department of Psychiatry and Medical Gastroenterology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India
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Alshaikh AA, Alamri SM, Riaz F, Mahmood SE, Shlwan MAM, Naser A Almuidh F, Alshahrani OAS, Asiri MAM, Almuaddi ASH, Al Qasim NYY, AlJebreel MAM, Ghazy RM. Exploring the burden of irritable bowel syndrome among university students in Saudi Arabia: A study on prevalence, psychological associations, and well-being. Medicine (Baltimore) 2024; 103:e38099. [PMID: 38728477 PMCID: PMC11081599 DOI: 10.1097/md.0000000000038099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
Patients with irritable bowel syndrome (IBS) experience not only a detrimental impact on their physical health but also a significant influence on their psychological well-being. This study aimed to assess the prevalence of IBS among university students, investigating the sociodemographic and lifestyle factors influencing its onset. Furthermore, it explored the potential impact of psychological factors such as depression, anxiety, and overall well-being on the prevalence of IBS. A cross-sectional analytical study was conducted at Saudi Arabian universities in November and December 2023. To collect data, an anonymous, validated, predesigned questionnaire was used. The diagnosis of IBS was carried out using the validated Arabic version of the Rome IV questionnaire. We used the Arabic version of the World Health Organization Well-being Index to assess the participants' well-being. We used the Arabic version of the Hospital Anxiety and Depression Scale (HADS) to identify people who show clinically significant symptoms of anxiety and depression. Our study included a total of 379 university students, 46.7% were female 86.0% of participants resided in urban areas, and 7.2% had been previously diagnosed with IBS. The prevalence of IBS among participants was found to be 31.9%. We observed a significant association between marital status and IBS (χ2 = 3.95, P = .047). Furthermore, the highest prevalence of IBS was observed among students majoring in literary and scientific disciplines (χ2 = 0.952, P = .049). Individuals with IBS demonstrate a significantly higher prevalence of anxiety (71.90% vs 41.09%, P < .001) and depression (64.46% vs 42.64%, P < .001) compared to those without IBS. Furthermore, people with IBS had a slightly higher prevalence of poor well-being (38.84%) compared to those without IBS (33.72%), but this association was not statistically significant. In multivariate analysis, having a family history of IBS [OR = 1.75 (95% CI, 1.06-2.87), P = .029] having borderline anxiety [OR = 7.58, 95% CI (2.12-27.06), P = .012] and anxiety [OR = 16.07, 95% CI (4.57-56.52), P < .001], and depression [OR = 2.97, 95% CI (1.13-7.83), P = .010] were the main significant predictors of IBS among university students. The high prevalence of IBS among university students was associated with a family history of IBS as well as depression and anxiety. Increasing awareness, multidisciplinary support, and access to mental health services is required to ensure university students' well-being.
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Affiliation(s)
- Ayoub Ali Alshaikh
- Family and Community Medicine Department, King Khalid University, Abha, Saudi Arabia
| | | | - Fatima Riaz
- Family and Community Medicine Department, King Khalid University, Abha, Saudi Arabia
| | - Syed Esam Mahmood
- Family and Community Medicine Department, King Khalid University, Abha, Saudi Arabia
| | | | | | | | | | | | | | | | - Ramy Mohamed Ghazy
- Family and Community Medicine Department, King Khalid University, Abha, Saudi Arabia
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Taghvaeinia A, Karami M, Azizi A. Comparison of the Effect of Dialectical Behavior Therapy, Acceptance and Commitment Therapy mindfulness-based Stress Reduction on Irritable Bowel Syndrome Symptoms, Quality of Life, Anxiety and Depression: A Pilot Randomized Controlled Trial. Psychiatr Q 2024; 95:53-68. [PMID: 37976011 DOI: 10.1007/s11126-023-10058-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/19/2023]
Abstract
This study aimed to compare dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT) and mindfulness based stress reduction (MBSR) effects on irritable bowel syndrome (IBS) symptoms, quality of life (QOL), anxiety and depression among patients with IBS. Eighty three eligible patients with a Rome- IV diagnosis were randomly allocated in DBT, MBSR, ACT, and control groups (n = 22 per group). All the patients were evaluated for IBS symptoms by IBS Severity Scoring System (IBS-SSS), QOL by irritable bowel syndrome quality of life (IBS-QOL), anxiety by Beck's Anxiety Inventory (BAI) and depression by Beck Depression Inventory- II (BDI-II) on the studied groups at the time of their inclusion in the study and 8 weeks after it. Each of the intervention groups took part in 8 group sessions. Conversely, the control group were evaluated without any intervention. 54 male and 29 female in 4 groups completed the study: DBT (n = 20), MBSR (n = 19), ACT (n = 22), and control groups (n = 22). The results showed significant differences between the groups based on the variables of the IBS-SSS, IBS-QOL, BAI and BDI-II (p < 0.05). Furthermore, the ACT intervention had considerably lower levels of IBS symptoms, anxiety, and depression compared to the other groups; also, the significant impacts of the QOL variable showed the higher scores of the ACT compared to the treatment groups. The therapies could not be applied to other groups of people. Other shortcomings were the absence of a follow-up strategy. This research offers preliminary evidence that ACT is more successful than other therapy groups in reducing IBS symptoms, anxiety and sadness, and improving QOL in IBS patients.
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Affiliation(s)
- Ali Taghvaeinia
- Department of Education and Psychology, Faculty of Humanities, Yasouj University, Yasouj, Iran.
| | - Mansoureh Karami
- Department of Education and Psychology, Faculty of Humanities, Yasouj University, Yasouj, Iran
| | - Amir Azizi
- Department of Psychology, Faculty of Humanities, Lorestan University, Lorestan, Iran
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13
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Bárdos G. Irritable bowel syndrome (IBS): could we decide what is behind? Biol Futur 2024; 75:61-71. [PMID: 38386191 DOI: 10.1007/s42977-024-00205-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
Functional visceral problems are frequently present nowadays in the medical practice probably due to the significant mental and emotional load on people. Although physicians and psychophysiologists are active on the field, still we are far from a complete knowledge, despite the fact that scientists like the Hungarian Professor György Ádám already had initiated a new approach called visceral psychophysiology already a long time ago. In this article, we commemorate Professor Ádám by analyzing one of the most frequent functional disorders, irritable bowel syndrome (IBS), calling psychophysiology for help. First, we try to give a definition, then show the general descriptions and characteristics of IBS. Factors like stress, gender, and gastrointestinal pain are followed by the potential role of the immune system and the neuronal factors as well as the supposed brain mechanisms. We hope that this overview of the IBS-history would show how significant scientists can be decisive in certain fields of the science and practice.
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Affiliation(s)
- György Bárdos
- Institute of Health Promotion and Sport Sciences, Faculty of Education and Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
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14
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Zhao Z, Bai B, Wang S, Zhou Y, Yu P, Zhao Q, Yang B. Physical and psychological correlates of somatic symptom in patients with functional constipation: a cross-sectional study. BMC Psychiatry 2024; 24:134. [PMID: 38365647 PMCID: PMC10873943 DOI: 10.1186/s12888-024-05559-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/25/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The symptoms of functional constipation (FC) were obviously affected by mental symptoms, which was consistent with somatic symptoms. However, the characteristics of FC patients with somatic symptom remains unexplored. METHODS Clinical characteristics including somatic symptom (SOM, PHQ-15), depression (PHQ-9), anxiety (GAD-7), quality of life (PAC-QOL), constipation (KESS), demographic variables, anatomical abnormalities and symptoms were investigated. Subsequent analyses encompassed the comparison of clinical parameters between patients with SOM + group (PHQ-15 ≥ 10) and SOM- group (PHQ-15 < 10), subgroup analysis, correlation analysis, and logistic regression. Lastly, we evaluated the somatic symptom severity (SSS) among FC patients subjected to various stressors. RESULTS Notable disparities were observed between SOM + and SOM- groups in variety of physiological and psychological variables, including gender, stressful events, sleep disorders, reduced interest, GAD-7, PHQ-15, PHQ-9, PAC-QOL, anterior rectocele, KESS, and internal anal sphincter achalasia (IASA) (P < 0.05). Subgroup analysis affirmed consistent findings across mental symptoms. Correlation analyses revealed significant associations between SSS and KESS, anterior rectocele, GAD-7, PHQ-9, and PAC-QOL (P < 0.05). Logistic regression identified PHQ-9 (OR = 7.02, CI: 2.06-27.7, P = 0.003), GAD-7 (OR = 7.18, CI: 2.00-30.7, P = 0.004), and KESS (OR = 16.8, CI: 3.09-113, P = 0.002) as independent predictors of SSS. Elevated SSS scores were significantly associated with couple, parental, and work-related stressors (P < 0.05). CONCLUSION A marked heterogeneity was observed between SOM + and SOM- patients of FC, with SOM + accompanied by more severe constipation, anxiety and depression symptoms. This finding underscores the importance of considering somatic symptoms in diagnosis and treatment of FC.
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Affiliation(s)
- Zhifeng Zhao
- State Key Laboratory of Cancer Biology & National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, No.127, West Changle Road, 710032, Xi'an, Shaanxi Province, People's Republic of China
| | - Bin Bai
- State Key Laboratory of Cancer Biology & National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, No.127, West Changle Road, 710032, Xi'an, Shaanxi Province, People's Republic of China
| | - Shiqi Wang
- State Key Laboratory of Cancer Biology & National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, No.127, West Changle Road, 710032, Xi'an, Shaanxi Province, People's Republic of China
| | - Yin Zhou
- State Key Laboratory of Cancer Biology & National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, No.127, West Changle Road, 710032, Xi'an, Shaanxi Province, People's Republic of China
| | - Pengfei Yu
- State Key Laboratory of Cancer Biology & National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, No.127, West Changle Road, 710032, Xi'an, Shaanxi Province, People's Republic of China
| | - Qingchuan Zhao
- State Key Laboratory of Cancer Biology & National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, No.127, West Changle Road, 710032, Xi'an, Shaanxi Province, People's Republic of China.
| | - Bin Yang
- State Key Laboratory of Cancer Biology & National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Air Force Medical University, No.127, West Changle Road, 710032, Xi'an, Shaanxi Province, People's Republic of China.
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Sun S, Chen J, Li H, Lou Y, Chen L, Lv B. Patients' perspectives on irritable bowel syndrome: a qualitative analysis based on social media in China. Qual Life Res 2023; 32:2561-2571. [PMID: 37093542 PMCID: PMC10123591 DOI: 10.1007/s11136-023-03417-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
AIM To explore the perspectives, experience, and concerns of patients with irritable bowel syndrome (IBS) in China. METHODS We used data mining to investigate posts shared in Baidu Tieba concerned with IBS; we collected the data through the crawler code, and mined the cleaned data's themes based on Latent Dirichlet allocation (LDA) and the Grounded theory. RESULTS We found 5746 network posts related to IBS. LDA analysis generated 20 topics, and grounded theory analysis established eight topics. Combining the two methods, we finally arranged the topics according to five concepts: difficulty in obtaining disease information; serious psychosocial problems; dissatisfied with the treatment; lack of social support; and low quality of life. CONCLUSION Social media research improved patient-centric understanding of patients' experiences and perceptions. Our study may facilitate doctor-patient communication and assist in the formulation of medical policies.
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Affiliation(s)
- Shaopeng Sun
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiajia Chen
- Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Heng Li
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yijie Lou
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lixia Chen
- Nursing College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Bin Lv
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China.
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16
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Pareki G, Wozniak A, Abegunde AT. Diagnosis of Irritable Bowel Syndrome: Primary Care Physicians Compared with Gastroenterologists. Clin Med Res 2023; 21:129-135. [PMID: 37985167 PMCID: PMC10659134 DOI: 10.3121/cmr.2023.1817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/22/2023] [Accepted: 07/11/2023] [Indexed: 11/22/2023]
Abstract
Objective: To examine disparities between primary care provider (PCP) and gastroenterologist diagnosis and management of irritable bowel syndrome (IBS).Design: Retrospective cross-sectional study.Setting: A 547-bed quaternary-care hospital within the Loyola University Healthcare System.Participants: 1000 patients aged 18-65 with an ICD-10 diagnosis of IBSMethods: We randomly selected 1000 patients aged 18 to 65 years within the Loyola University Healthcare System's electronic medical record with an ICD-10 diagnosis of IBS. Physician notes and diagnostic results were reviewed for documentation of symptoms fulfilling Rome IV criteria and resolution of symptoms. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of primary diagnoses assigned by PCPs and gastroenterologists were assessed along with number of diagnostic tests ordered.Results: The mean age (SD) was 45 (12) years, and 76.9% were female. Sensitivity of an IBS diagnosis by a PCP was 77.6% (95% CI 73.3-81.9), compared with 60.1% (95% CI 54.7-65.6) for a gastroenterologist. Specificity of an IBS diagnosis by a PCP was 27.5% (95% CI 23.5-31.5), compared with 71.1% (95% CI 64.6-77.5) for a gastroenterologist diagnosis of IBS. A gastroenterologist diagnosis of IBS carried a high PPV (77.3%, 95% CI 72.0-82.6) compared with 44.6% (95% CI 40.7-48.5) for a PCP. Of 180 patients with outcome data, 69.4% had resolution of symptoms at follow-up.Conclusion: The sensitivity of gastroenterologist diagnosis of IBS closely matches the sensitivity of Rome IV criteria in validation studies. The high specificity and PPV of gastroenterologists suggest more cautious diagnosis by gastroenterologists, with PCPs more likely to assign a diagnosis of IBS incorrectly or without sufficient documentation of symptoms fulfilling Rome IV criteria. Reported resolution rates suggest primary care management of IBS is appropriate, but PCPs may benefit from gastroenterologist consultation and diagnostic guidelines for greater specificity in diagnosing IBS.
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Affiliation(s)
- Genevieve Pareki
- Loyola University Chicago, Stritch School of Medicine, Chicago, Illinois
| | - Amy Wozniak
- Loyola University Chicago, Clinical Research Office Biostatistics Collaborative Core, Chicago, Illinois
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17
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Sarvepalli SS, Vemula SL, Aramadaka S, Mannam R, Sankara Narayanan R, Bansal A, Yanamaladoddi VR. Digesting the Impact of Diet on Irritable Bowel Syndrome (IBS): Exploring Solutions for Controlling IBS. Cureus 2023; 15:e45279. [PMID: 37846263 PMCID: PMC10576851 DOI: 10.7759/cureus.45279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/18/2023] Open
Abstract
Irritable bowel syndrome (IBS) plagues nearly a fifth of the general population. It is a chronic illness that can significantly lower quality of life (QoL) and work productivity. The relationship between diet and the functional gastrointestinal (GI) symptoms present in IBS is gaining more and more attention. In addition to being a factor in the pathophysiology of IBS, diet also has a significant impact on symptoms and overall well-being. Recent research has also shown that short-chain fermentable carbohydrates increase colonic gas production and small intestine water volume, which in turn causes functional GI symptoms in those with visceral hypersensitivity. This review article has consolidated various studies highlighting the association between certain foods and the pathophysiology of IBS. It has also talked about how restricting certain food items from the diet of affected individuals can relieve symptoms and in some cases can be more effective than pharmacotherapy. Although the low reduced fermentable oligosaccharide, disaccharide, monosaccharide, and polyol (FODMAP) diet (LFD) is a well-known method of treating IBS symptoms, over a third of individuals do not benefit from it. This article has also discussed the effectiveness and applicability of the LFD compared to other dietary therapies for the long-term management of IBS.
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Affiliation(s)
| | - Shree Laya Vemula
- Department of Research, Anam Chenchu Subba Reddy (ACSR) Government Medical College, Nellore, IND
| | | | - Raam Mannam
- Department of General Surgery, Narayana Medical College, Nellore, IND
| | | | - Arpit Bansal
- Department of Research, Narayana Medical College, Nellore, IND
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18
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Nasiri-Dehsorkhi H, Vaziri S, Esmaillzadeh A, Adibi P. Psychological distress, perceived stress and nocebo effect (multifood adverse reaction) in irritable bowel syndrome patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:257. [PMID: 37727431 PMCID: PMC10506782 DOI: 10.4103/jehp.jehp_221_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/03/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Psychological distress and perceived stress may complicate the clinical presentation, course, and treatment of patients with functional gastrointestinal disorders. The correlation between psychological distress, perceived stress, and the nocebo effect (multifood adverse reaction) in patients with irritable bowel syndrome (IBS) was the main aim of the present study. MATERIALS AND METHODS In this cross-sectional correlation study, data on 4,763 Iranian adults, 748 of whom by purposive sampling were patients with IBS (65.1% female), working in 50 different health centers affiliated to the Isfahan University of Medical Sciences across Isfahan province were examined. For assessing dietary intake, a 106-item self-administered Dish-based Semi-Quantitative Food Frequency Questionnaire that was specifically designed and validated for Iranian adults was used. General Heath Questionnaire 12 and Stressful Life event Questionnaire were used to assess psychological distress and perceived stress. By using a modified Persian version of the Rome III questionnaire, IBS was assessed. Based on researcher-made definition of nocebo effect (multiitem food intolerance), 164 people had the nocebo phenomenon in IBS group. RESULTS Age, sex, education, marital status, antidepressant use, and specifically chronic underlying disease (odds ratio [OR]: 3.54, 95% confidence interval [CI]: 1.73-7.23) of general characteristics had a significant correlation (P <.05) with presenting nocebo responses in IBS patients. Psychological distress (OR: 1.415; 95% CI: 0.992-2.020; P = 0.056) had a significant correlation with nocebo effect and did not find significant correlation with perceived stress (OR: 0.999; 95% CI: 0.990-1.008; P = 0.865). Data were analyzed by Chi-square test, analysis of variance, and OR. CONCLUSION The present study showed that psychological distress with chronic underlying disease and antidepressant use are important elements in presenting multifood adverse reactions that we named here as the nocebo effect in IBS patients. Reducing psychological distress and managing chronic underlying diseases appear to be an effective factor in reducing the nocebo phenomenon in IBS patients. For managing the nocebo responses in IBS patients, these findings may help clinicians to improve their interventions. Further studies are required to confirm these findings.
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Affiliation(s)
- Hamid Nasiri-Dehsorkhi
- Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Vaziri
- Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Traini C, Idrizaj E, Biagioni C, Baccari MC, Vannucchi MG. Otilonium Bromide Prevents Cholinergic Changes in the Distal Colon Induced by Chronic Water Avoidance Stress, a Rat Model of Irritable Bowel Syndrome. Int J Mol Sci 2023; 24:ijms24087440. [PMID: 37108603 PMCID: PMC10139220 DOI: 10.3390/ijms24087440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Irritable Bowel syndrome (IBS) is a highly widespread gastrointestinal disorder whose symptomatology mainly affect the large intestine. Among the risk factors, psychosocial stress is the most acknowledged. The repeated water avoidance stress (rWAS) is considered an animal model of psychosocial stress that is capable of mimicking IBS. Otilonium bromide (OB), which is orally administered, concentrates in the large bowel and controls most of the IBS symptoms in humans. Several reports have shown that OB has multiple mechanisms of action and cellular targets. We investigated whether the application of rWAS to rats induced morphological and functional alterations of the cholinergic neurotransmission in the distal colon and whether OB prevented them. The results demonstrated that rWAS affects cholinergic neurotransmission by causing an increase in acid mucin secretion, in the amplitude of electrically evoked contractile responses, abolished by atropine, and in the number of myenteric neurons expressing choline acetyltransferase. OB counteracted these changes and also showed an intrinsic antimuscarinic effect on the post-synaptic muscular receptors. We assume that the rWAS consequences on the cholinergic system are linked to corticotrophin-releasing factor-1 (CRF1) receptor activation by the CRF hypothalamic hormone. OB, by interfering with the CFR/CRFr activation, interrupted the cascade events responsible for the changes affecting the rWAS rat colon.
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Affiliation(s)
- Chiara Traini
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy
| | - Eglantina Idrizaj
- Section of Physiological Sciences, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy
| | - Cristina Biagioni
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy
| | - Maria Caterina Baccari
- Section of Physiological Sciences, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy
| | - Maria Giuliana Vannucchi
- Histology and Embryology Research Unit, Department of Experimental and Clinical Medicine, University of Florence, 50139 Florence, Italy
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20
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Louwies T, Mohammadi E, Greenwood-Van Meerveld B. Epigenetic mechanisms underlying stress-induced visceral pain: Resilience versus vulnerability in a two-hit model of early life stress and chronic adult stress. Neurogastroenterol Motil 2023; 35:e14558. [PMID: 36893055 DOI: 10.1111/nmo.14558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/16/2022] [Accepted: 02/19/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Women with a history of early life stress (ELS) have a higher risk of developing irritable bowel syndrome (IBS). In addition, chronic stress in adulthood can exacerbate IBS symptoms such as abdominal pain due to visceral hypersensitivity. We previously showed that sex and the predictability of ELS determine whether rats develop visceral hypersensitivity in adulthood. In female rats, unpredictable ELS confers vulnerability and results in visceral hypersensitivity, whereas predictable ELS induces resilience and does not induce visceral hypersensitivity in adulthood. However, this resilience is lost after exposure to chronic stress in adulthood leading to an exacerbation of visceral hypersensitivity. Evidence suggests that changes in histone acetylation at the promoter regions of glucocorticoid receptor (GR) and corticotrophin-releasing factor (CRF) in the central nucleus of the amygdala (CeA) underlie stress-induced visceral hypersensitivity. Here, we aimed to investigate the role of histone acetylation in the CeA on visceral hypersensitivity in a two-hit model of ELS followed by chronic stress in adulthood. METHODS Male and female neonatal rats were exposed to unpredictable, predictable ELS, or odor only (no stress control) from postnatal days 8 to 12. In adulthood, rats underwent stereotaxic implantation of indwelling cannulas. Rats were exposed to chronic water avoidance stress (WAS, 1 h/day for 7 days) or SHAM stress and received infusions of vehicle, the histone deacetylase inhibitor trichostatin A (TSA) or the histone acetyltransferase inhibitor garcinol (GAR) after each WAS session. 24 h after the final infusion, visceral sensitivity was assessed and the CeA was removed for molecular experiments. RESULTS In the two-hit model (ELS + WAS), female rats previously exposed to predictable ELS, showed a significant reduction in histone 3 lysine 9 (H3K9) acetylation at the GR promoter and a significant increase in H3K9 acetylation at the CRF promoter. These epigenetic changes were associated with changes in GR and CRF mRNA expression in the CeA and an exacerbation of stress-induced visceral hypersensitivity in female animals. TSA infusions in the CeA attenuated the exacerbated stress-induced visceral hypersensitivity, whereas GAR infusions only partially ameliorated ELS+WAS induced visceral hypersensitivity. CONCLUSION The two-hit model of ELS followed by WAS in adulthood revealed that epigenetic dysregulation occurs after exposure to stress in two important periods of life and contributes to the development of visceral hypersensitivity. These aberrant underlying epigenetic changes may explain the exacerbation of stress-induced abdominal pain in IBS patients.
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Affiliation(s)
- Tijs Louwies
- Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
| | - Ehsan Mohammadi
- Department of Physiology, University of Oklahoma Health Science Center, Oklahoma City, Oklahoma, USA
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21
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Meng P, Cheng B, Pan C, Liu L, Cheng S, Yang X, Chen Y, Li C, Zhang H, Zhang Z, Zhang J, He D, Shi S, Chu X, Cai Q, Zhang N, Qin X, Zhao Y, Wei W, Jia Y, Wen Y, Zhang F. Evaluating the role of anxiety on the association between irritable bowel syndrome and brain volumes: a mediation analysis in the UK Biobank cohort. Brain Commun 2023; 5:fcad116. [PMID: 37091589 PMCID: PMC10116581 DOI: 10.1093/braincomms/fcad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/24/2023] [Accepted: 04/07/2023] [Indexed: 04/25/2023] Open
Abstract
There is a strong link between irritable bowel syndrome and brain volumes, yet, to date, research examining the mediators of this association has been little. Based on the phenotypic data of 15 248 participants from the UK Biobank, a two-stage mediation analysis was performed to assess the association among brain volumes, anxiety, and irritable bowel syndrome. In the first stage, we identified the candidate mediating role of anxiety for irritable bowel syndrome associated with brain volumes using regression models. Then, we quantified the magnitude of the mediation effects by evaluating the average causal-mediated effect and proportion of mediation through performing mediation analyses in the R package in the second stage. In the first stage, we identified the partly mediating role of anxiety in the association between irritable bowel syndrome and the volume of thalamus (P left = 1.16 × 10-4, P right = 2.41 × 10-4), and grey matter (P left = 3.22 × 10-2, P right = 1.18 × 10-2) in the VIIIa cerebellum. In the second stage, we observed that the proportion of the total effect of irritable bowel syndrome on volume of thalamus mediated by anxiety was 14.3% for the left region (β Average causal-mediated effect = -0.008, P Average causal-mediated effect = 0.004) and 14.6% for the right region (β Average causal-mediated effect = -0.007, P Average causal-mediated effect = 0.006). Anxiety mediated 30.8% for the left region (β Average causal-mediated effect = -0.013, P Average causal-mediated effect = 0.002) and 21.6% for the right region (β Average causal-mediated effect = -0.010, P Average causal-mediated effect x= 0.018) of the total effect of irritable bowel syndrome on the volume of grey matter in the VIIIa cerebellum. Our study revealed the indirect mediating role of anxiety in the association between irritable bowel syndrome and brain volumes, promoting our understanding of the functional mechanisms of irritable bowel syndrome and its related psychosocial factors.
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Affiliation(s)
| | | | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Chun’e Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Huijie Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Zhen Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Jingxi Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Dan He
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Sirong Shi
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Xiaoge Chu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Qingqing Cai
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Na Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Xiaoyue Qin
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Yijing Zhao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Wenming Wei
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Feng Zhang
- Correspondence to: Feng Zhang Key Laboratory of Trace Elements and Endemic Diseases National Health Commission of the People’s Republic of China School of Public Health, Health Science Center Xi’an Jiaotong University, No. 76 Yan Ta West Road, Xi’an 710061, China E-mail:
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22
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Chi ZC. Progress in research of low-grade inflammation in irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2022; 30:1051-1065. [DOI: 10.11569/wcjd.v30.i24.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Irritable bowel syndrome (IBS) is a common intestinal disease with a prevalence of 10%-15%. However, its pathophysiology is still not completely clear, and it has long been considered as a functional disease. In recent years, it has been found that low-grade inflammation plays a pathogenic role in IBS. Studies have confirmed that there is persistent mucosal inflammation at the microscopic and molecular levels. This review discusses the evidence, role, and clinical relevance of mucosal inflammation in IBS. In addition to mucosal inflammation, neuroinflammation may lead to changes in neuroendocrine pathways and glucocorticoid receptor genes through the "gut-brain" axis, and thus cause IBS through proinflammatory phenotype and hypothalamic pituitary adrenal axis and 5-hydroxytryptamine dysfunction. The observation that IBS patients can benefit from anti-inflammatory therapy also confirms that IBS is associated with inflammation.
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Affiliation(s)
- Zhao-Chun Chi
- Department of Gastroenterology, Qingdao Municipal Hospital, Qingdao 266011, Shandong Province, China
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23
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Petitfils C, Maurel S, Payros G, Hueber A, Agaiz B, Gazzo G, Marrocco R, Auvray F, Langevin G, Motta JP, Floch P, Tremblay-Franco M, Galano JM, Guy A, Durand T, Lachambre S, Durbec A, Hussein H, Decraecker L, Bertrand-Michel J, Saoudi A, Oswald E, Poisbeau P, Dietrich G, Melchior C, Boeckxstaens G, Serino M, Le Faouder P, Cenac N. Identification of bacterial lipopeptides as key players in IBS. Gut 2022; 72:939-950. [PMID: 36241390 PMCID: PMC10086498 DOI: 10.1136/gutjnl-2022-328084] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/27/2022] [Indexed: 12/08/2022]
Abstract
OBJECTIVES Clinical studies revealed that early-life adverse events contribute to the development of IBS in adulthood. The aim of our study was to investigate the relationship between prenatal stress (PS), gut microbiota and visceral hypersensitivity with a focus on bacterial lipopeptides containing γ-aminobutyric acid (GABA). DESIGN We developed a model of PS in mice and evaluated, in adult offspring, visceral hypersensitivity to colorectal distension (CRD), colon inflammation, barrier function and gut microbiota taxonomy. We quantified the production of lipopeptides containing GABA by mass spectrometry in a specific strain of bacteria decreased in PS, in PS mouse colons, and in faeces of patients with IBS and healthy volunteers (HVs). Finally, we assessed their effect on PS-induced visceral hypersensitivity. RESULTS Prenatally stressed mice of both sexes presented visceral hypersensitivity, no overt colon inflammation or barrier dysfunction but a gut microbiota dysbiosis. The dysbiosis was distinguished by a decreased abundance of Ligilactobacillus murinus, in both sexes, inversely correlated with visceral hypersensitivity to CRD in mice. An isolate from this bacterial species produced several lipopeptides containing GABA including C14AsnGABA. Interestingly, intracolonic treatment with C14AsnGABA decreased the visceral sensitivity of PS mice to CRD. The concentration of C16LeuGABA, a lipopeptide which inhibited sensory neurons activation, was decreased in faeces of patients with IBS compared with HVs. CONCLUSION PS impacts the gut microbiota composition and metabolic function in adulthood. The reduced capacity of the gut microbiota to produce GABA lipopeptides could be one of the mechanisms linking PS and visceral hypersensitivity in adulthood.
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Affiliation(s)
- Camille Petitfils
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Sarah Maurel
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Gaelle Payros
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Amandine Hueber
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Bahija Agaiz
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Géraldine Gazzo
- Institut des Neurosciences Cellulaire et Integrative (INCI), Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Rémi Marrocco
- INFINITY, Université de Toulouse-Paul Sabatier, INSERM, CNRS, UPS, Toulouse, France
| | - Frédéric Auvray
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Geoffrey Langevin
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Jean-Paul Motta
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Pauline Floch
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France.,Service de bactériologie-hygiène, CHU Toulouse, Hôpital Purpan, Toulouse, France
| | - Marie Tremblay-Franco
- Toxalim (Research Center in Food Toxicology), Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France.,Metatoul-AXIOM Platform, MetaboHUB, Toxalim, INRAE, Toulouse, France
| | - Jean-Marie Galano
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Alexandre Guy
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, Montpellier, France
| | - Simon Lachambre
- INFINITY, Université de Toulouse-Paul Sabatier, INSERM, CNRS, UPS, Toulouse, France
| | - Anaëlle Durbec
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Hind Hussein
- Laboratory of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Lisse Decraecker
- Laboratory of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Justine Bertrand-Michel
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Abdelhadi Saoudi
- INFINITY, Université de Toulouse-Paul Sabatier, INSERM, CNRS, UPS, Toulouse, France
| | - Eric Oswald
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France.,Service de bactériologie-hygiène, CHU Toulouse, Hôpital Purpan, Toulouse, France
| | - Pierrick Poisbeau
- Institut des Neurosciences Cellulaire et Integrative (INCI), Centre National de la Recherche Scientifique, Université de Strasbourg, Strasbourg, France
| | - Gilles Dietrich
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Chloe Melchior
- Gastroenterology Department, Rouen University Hospital, Rouen, France.,Institute for Research and Innovation in Biomedicine, INSERM CIC-CRB 1404, INSERM UMR 1073, Normandy University, Rouen, France.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Guy Boeckxstaens
- Laboratory of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Matteo Serino
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
| | - Pauline Le Faouder
- Lipidomic, MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, Toulouse, France.,I2MC, Université de Toulouse, Inserm, Université Toulouse III - Paul Sabatier (UPS), Toulouse, France
| | - Nicolas Cenac
- IRSD, Université de Toulouse-Paul Sabatier, INSERM, INRAe, ENVT, UPS, Toulouse, France
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24
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Association between Serum Vitamin D and Irritable Bowel Syndrome Symptoms in a Sample of Adults. Nutrients 2022; 14:nu14194157. [PMID: 36235809 PMCID: PMC9573646 DOI: 10.3390/nu14194157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 12/01/2022] Open
Abstract
Vitamin D may be associated with irritable bowel syndrome (IBS) pathways. This cross-sectional study evaluated the associations between serum Vitamin D and IBS symptoms in a sample of Lebanese adults. Participants (n = 230; mean (SD) age: 43.36 (16.05) years, 62.9% females) were adults, free of diseases affecting Vitamin D metabolism, and recruited from a large university and the surrounding community. Serum Vitamin D (25-hydroxyvitamin D) was assessed using an automated chemiluminescence micro-particle immunoassay kit. The Birmingham IBS Symptom Questionnaire total scale, and pain, constipation, and diarrhea subscales were used to study IBS symptoms. Four linear regression analyses were performed, taking respectively the total scale and each of the subscales as the dependent variable. Vitamin D was forced into each model. Covariates included sociodemographic and medical variables, fluid intake, physical activity, sleep quality, stress, and adherence to the Mediterranean diet. Mean (SD) serum Vitamin D was 17.53 (12.40) ng/mL and mean (SD) Birmingham IBS Symptom Questionnaire was 16.98 (15.16) (pain: 20.75 (23.63), constipation: 25.06 (29.99), diarrhea: 9.88 (13.37)). Serum Vitamin D was not associated with the total score, nor with any of the subscales (p > 0.05 for the four regression analyses). Serum Vitamin D was not associated with IBS symptoms in a sample of Lebanese adults, adding to the controversy in this field. Further understanding of the pathophysiological mechanisms involved in Vitamin D and IBS is warranted.
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25
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Zeeshan MH, Vakkalagadda NP, Sree GS, Anne KK, devi S, Parkash O, Fawwad SBU, Haider SMW, Mumtaz H, Hasan M. Irritable bowel syndrome in adults: Prevalence and risk factors. Ann Med Surg (Lond) 2022; 81:104408. [PMID: 36147064 PMCID: PMC9486601 DOI: 10.1016/j.amsu.2022.104408] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction The prevalence of irritable bowel syndrome (IBS) ranges from 7 to 18% over the world. We aimed to assess the prevalence and risk factors of irritable bowel syndrome in adults. Methodology We conducted a cross-sectional study of IBS prevalence and risk factors from March to May 2022 at KRL Hospital Islamabad. 300 people were given Pre-validated Performa's. Our research adheres to the principles outlined in the Helsinki Declaration. The PSS was used to measures how much stress a person has felt in the past month. The higher the score, the more stressed the person appears to be. A variety of mental health disorders can be evaluated using this method. Data on dietary and lifestyle factors associated with IBS for the last 12 months was also collected from the participants. Results The majority of patients, 70%, were classed as Grade 1 and 146 (48.66%) reported abdominal pain associated with defecation. 162 (54%) individuals reported high levels of tea consumed, 81 (27%) consumed coffee and 57 (19%) reported carbonated drinks consumed. 139 individuals reported having Vigorous-Intensity activity, out of which 69 (49.64%) spend 60 min of vigorous activity in a day. Conclusion Screening patients for IBS on a regular basis is critical, especially in the younger demographic. If a patient experiences any symptoms of IBS, they should contact their doctor immediately. Consider the care of patients with chronic gastrointestinal complaints, particularly in women and those at greater risk of developing the illness.
Perceived Stress Scale (PSS) measures how much stress a person has felt in the past month. The Chalder Fatigue Scale (CFS) is used to measure fatigue. We recommend the younger population to be screened for IBS on a regular basis. Persistent gastrointestinal symptoms, especially women and those at high risk of the condition, it is critical to take this into account.
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26
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Louwies T, Greenwood-Van Meerveld B. Chronic stress increases DNA methylation of the GR promoter in the central nucleus of the amygdala of female rats. Neurogastroenterol Motil 2022; 34:e14377. [PMID: 35411658 DOI: 10.1111/nmo.14377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/17/2022] [Accepted: 03/26/2022] [Indexed: 02/08/2023]
Abstract
The central pathophysiological mechanisms underlying irritable bowel syndrome (IBS), a female-predominant gastrointestinal disorder characterized by abdominal pain and abnormal bowel habits, remain poorly understood. IBS patients often report that chronic stress exacerbates their symptoms. Brain imaging studies have revealed that the amygdala, a stress-responsive brain region, of IBS patients is overactive when compared to healthy controls. Previously, we demonstrated that downregulation of the glucocorticoid receptor (GR) in the central nucleus of the amygdala (CeA) underlies stress-induced visceral hypersensitivity in female rats. In the current study, we aimed to evaluate in the CeA of female rats whether chronic water avoidance stress (WAS) alters DNA methylation of the GR exon 17 promoter region, a region homologous to the human GR promoter. As histone deacetylase (HDAC) inhibitors are able to change DNA methylation, we also evaluated whether administration of the HDAC inhibitor trichostatin A (TSA) directly into the CeA prevented WAS-induced increases in DNA methylation of the GR exon 17 promoter. We found that WAS increased overall and specific CpG methylation of the GR promoter in the CeA of female rats, which persisted for up to 28 days. Administration of the TSA directly into the CeA prevented these stress-induced changes of DNA methylation at the GR promoter. Our results suggest that, in females, changes in DNA methylation are involved in the regulation of GR expression in the CeA. These changes in DNA methylation may contribute to the central mechanisms responsible for stress-induced visceral hypersensitivity.
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Affiliation(s)
- Tijs Louwies
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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27
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Shi YZ, Ye K, Chen M, Xie X, Fan XY, Xie CR, Tao QF, Hua C, Wu QP, Jiang XH, Wan YY, Li ZG, Zheng H, Yu SG. Acupuncture for irritable bowel syndrome: study protocol of a prospective, multicentre, registry study in real-world settings. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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28
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Ivashkin VT, Morozova MA, Poluektova EA, Shifrin OS, Beniashvili AG, Rupchev GE, Alekseev AA, Poluektov YM, Mamieva ZA, Kovaleva AL, Ulyanin AI, Trush EA. The Effectiveness of Add-on Treatment with Nutraceutical. RUSSIAN JOURNAL OF GASTROENTEROLOGY, HEPATOLOGY, COLOPROCTOLOGY 2022; 32:35-44. [DOI: 10.22416/1382-4376-2022-32-2-35-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
Abstract
Aim:evaluation of the effectiveness of the nutraceutical “Standard Zdorovia: Gastro” (“SZ Gastro”) in the treatment of patients with irritable bowel syndrome (IBS).Materials and methods.52 patients (62 % women) diagnosed with IBS and IBS in combination with functional dyspepsia (FD) were included in the study and divided into two groups. Both groups received basic therapy according to the guidelines. The experimental group received as add-on the nutraceutical “SZ Gastro” (containing a standardized amount of menthol, gingerol and D-limonene); patients in the control group — placebo. The duration of the study was 30 days. The severity of somatic symptoms was assessed with the 7×7 questionnaire. Emotional state was assessed with the Four Dimensional Distress, Depression, Anxiety, and Somatization Questionnaire (4DSQ).Results.Patients of the experimental and control groups did not differ from each other either in terms of demographics, basic treatment, or in the severity of symptoms at the beginning of the study.The effectiveness of the treatment in the patients, who received add-on “SZ Gastro” was significantly higher than in the patients of the control group: in the control group the percentage of improvement of somatic symptoms was 22.35 %, in the experimental group it amounted to 49.18 % (χ2= 15.9;p= 0.0001). The percentage of patients with significant decrease of emotional disturbances was also higher in the experimental group: distress (χ2= 18.7;p= 0.0000), anxiety (χ2= 6.9;p= 0.0097) and somatization (χ2= 14.99;p= 0.0001). No significant side effects were registered in any of the groups.Conclusions.Add-on of nutraceutical “SZ Gastro” to basic treatment is safe and significantly increases effectiveness of the therapy in the patients with IBS and IBS in combination with PD.
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Affiliation(s)
- V. T. Ivashkin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | - E. A. Poluektova
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - O. S. Shifrin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | | | | | - Yu. M. Poluektov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences
| | - Z. A. Mamieva
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. L. Kovaleva
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - A. I. Ulyanin
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
| | - E. A. Trush
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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29
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Yang W, Yang X, Cai X, Zhou Z, Yao H, Song X, Zhao T, Xiong P. The Prevalence of Irritable Bowel Syndrome Among Chinese University Students: A Systematic Review and Meta-Analysis. Front Public Health 2022; 10:864721. [PMID: 35493361 PMCID: PMC9051230 DOI: 10.3389/fpubh.2022.864721] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) has become a common public health issue among university students, impairing their physical and mental health. This meta-analysis aimed to examine the pooled prevalence of IBS and its associated factors among Chinese university students. METHODS Databases of PubMed, EMBASE, MEDLINE (via EBSCO), CINAHL (via EBSCO), Wan Fang, CNKI and Weipu (via VIP) were systematically searched from inception date to May 31, 2021. Meta-analysis was performed using random-effects models. Meta-regression and subgroup analysis were used to detect the potential source of heterogeneity. KEY RESULTS A total of 22 cross-sectional studies (14 were in Chinese and 8 were in English) with 33,166 Chinese university students were included. The pooled prevalence of IBS was estimated as 11.89% (95% CI = 8.06%, 16.35%). The prevalence was 10.50% (95% CI = 6.80%, 15.87%) in Rome II criteria, 12.00% (95% CI = 8.23%, 17.17%) in Rome III criteria, and 3.66% (95% CI = 2.01%, 6.60%) in Rome IV criteria. The highest prevalence of IBS was 17.66% (95% CI = 7.37%, 36.64%) in North China, and the lowest was 3.18% (95% CI = 1.28%, 7.68%) in South China. Subgroup analyses indicated that gender, major, anxiety and depression symptoms, drinking and smoking behaviors were significantly associated with the prevalence of IBS. Meta-regression analyses suggested that region influenced prevalence estimates for IBS. CONCLUSIONS AND INFERENCES This meta-analysis illustrated that IBS is very common in Chinese university students. Regular screening, effective prevention, and appropriate treatments should be implemented to reduce the risk of IBS in this population. More future studies should be conducted in Northeastern and Southwestern parts of China.
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Affiliation(s)
- Weixin Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xiao Yang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xianghao Cai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Zhuoren Zhou
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Huan Yao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xingrong Song
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Tianyun Zhao
- Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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McNaughton DT, Andreasson A, Ljótsson B, Beath AP, Hush JM, Ljunggren G, Schmidt PT, Talley NJ, Agréus L, Jones MP. Limited evidence of moderation of the association between gastrointestinal symptoms and prospective healthcare utilisation by quality of life. Aliment Pharmacol Ther 2022; 55:311-317. [PMID: 34664298 DOI: 10.1111/apt.16651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/01/2021] [Accepted: 10/04/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND An individual's drive to seek medical help remains a complex behavioural process, incorporating psychological, social and symptom-specific factors. Within irritable bowel syndrome (IBS), gastrointestinal symptoms only predict a small portion of the high healthcare-seeking experienced. AIM To examine the moderating role of quality of life (QoL) domains on this relationship to help explain the variance observed. METHODS This is an analysis of a Swedish population-based prospective study of healthcare use over a 12-year period. At baseline, gastrointestinal symptoms were measured with the valid Gastrointestinal Symptom Rating Scale, and QoL via the SF-36. 1159 subjects (57% female; mean age 48.6 years) had their health records matched with the initial survey. 164 were classified as IBS by Rome II criteria. Negative binomial or logistic models were fit to evaluate the moderating effect of particular QoL domains on the relationship between gastrointestinal symptoms and prospective healthcare utilisation. RESULTS Gastrointestinal symptoms were associated with prospective healthcare use, but moderation in this relationship by particular QoL domains was not supported; most models did not reach statistical significance. Furthermore, the impact of IBS status did not alter the moderation hypotheses. CONCLUSIONS Particular QoL domains did not impact the relationship between gastrointestinal symptoms on prospective healthcare seeking. Future research should continue to examine other psychological, social and symptom variables to identify predictors of high healthcare consumers in IBS.
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Affiliation(s)
- David T McNaughton
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Anna Andreasson
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia.,Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Alissa P Beath
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Julia M Hush
- Department of Health Professions, Macquarie University, Sydney, NSW, Australia
| | - Gunnar Ljunggren
- Academic Primary Health Care Centre, Stockholm, Sweden.,Public Healthcare Services Committee Administration, Stockholm, Sweden
| | - Peter T Schmidt
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Nicholas J Talley
- Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Lars Agréus
- Academic Primary Health Care Centre, Stockholm, Sweden
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
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Kumar S, Singh P, Kumar A. Targeted therapy of irritable bowel syndrome with anti-inflammatory cytokines. Clin J Gastroenterol 2022; 15:1-10. [PMID: 34862947 PMCID: PMC8858303 DOI: 10.1007/s12328-021-01555-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 10/14/2021] [Indexed: 12/17/2022]
Abstract
Irritable bowel syndrome (IBS) is a multifactorial disease of which infection, as well as inflammation, has recently been considered as an important cause. Inflammation works as a potential pathway for the pathogenesis of IBS. In this review, we have discussed the targeted therapy of IBS. We used the search term "inflammation in IBS" and "proinflammatory" and "antiinflammatory cytokines and IBS" using PubMed, MEDLINE, and Google Scholar. The literature search included only articles written in the English language. We have also reviewed currently available anti-inflammatory treatment and future perspectives. Cytokine imbalance in the systematic circulation and the intestinal mucosa may also characterize IBS presentation. Imbalances of pro-and anti-inflammatory cytokines and polymorphisms in cytokine genes have been reported in IBS. The story of targeted therapy of IBS with anti-inflammatory cytokines is far from complete and it seems that it has only just begun. This review describes the key issues related to pro-inflammatory cytokines associated with IBS, molecular regulation of immune response in IBS, inhibitors of pro-inflammatory cytokines in IBS, and clinical perspectives of pro- and anti-inflammatory cytokines in IBS.
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Affiliation(s)
- Sunil Kumar
- Faculty of Bio-Sciences, Institute of Bio-Sciences and Technology, Shri Ramswaroop Memorial University, Lucknow- Deva Road, Barabanki, 225003, Uttar Pradesh, India.
| | - Priyanka Singh
- Faculty of Bio-Sciences, Institute of Bio-Sciences and Technology, Shri Ramswaroop Memorial University, Lucknow- Deva Road, Barabanki, 225003, Uttar Pradesh, India
| | - Awanish Kumar
- Department of Biotechnology, National Institute of Technology, Raipur, Chhattisgarh, India.
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Barandouzi ZA, Lee J, Del Carmen Rosas M, Chen J, Henderson WA, Starkweather AR, Cong XS. Associations of neurotransmitters and the gut microbiome with emotional distress in mixed type of irritable bowel syndrome. Sci Rep 2022; 12:1648. [PMID: 35102266 PMCID: PMC8803858 DOI: 10.1038/s41598-022-05756-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 01/12/2022] [Indexed: 02/08/2023] Open
Abstract
Evidence highlights the comorbidity between emotional distress and irritable bowel syndrome (IBS) through the gut-brain axis. However, the underlying mechanism is largely unknown. Thus, the present study aimed to evaluate the associations among neurotransmitter levels and the gut microbiome profiles in persons with IBS and emotional distress. In this nested case-controlled study, emotional symptoms, including anxiety and depressive symptoms, were evaluated in 40 persons with IBS and 20 healthy controls (HC). Plasma neurotransmitters levels (serotonin and norepinephrine) and the gut microbiome profile of the collected fecal samples were examined. Emotional distress and microbiome profile were significantly different between IBS and HC groups. Lower but not significant neurotransmitters' levels (serotonin and norepinephrine) were observed in the IBS group compared to the HC. A negative correlation was found between norepinephrine levels and alpha diversity (Shannon and Simpson indices) in the IBS group. Moreover, serotonin levels were positively associated with the abundance of Proteobacteria, and norepinephrine were positively correlated with Bacteroidetes, but negatively associated with Firmicutes phylum. The present study demonstrated alteration in the gut microbiome between persons with IBS and emotional distress compared to HC. The correlations between plasma neurotransmitters and the gut microbiome suggest that the gut microbiome may impact the regulation of neurotransmitters.
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Affiliation(s)
- Zahra A Barandouzi
- School of Nursing, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs, CT, 06269-4026, USA
- School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, 30322, USA
| | - Joochul Lee
- Department of Statistics, University of Connecticut, 215 Glenbrook Road, U-4120, Storrs, CT, 06269-4120, USA
- Department of Biostatistics and Epidemiology, University of Pennsylvania, 423 Guardian Dr, Philadelphia, PA, 19104, USA
| | - Maria Del Carmen Rosas
- School of Nursing, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs, CT, 06269-4026, USA
| | - Jie Chen
- School of Nursing, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs, CT, 06269-4026, USA
- School of Nursing, University of Maryland, 655 W Lombard St, Baltimore, MD, 21201, USA
| | - Wendy A Henderson
- School of Nursing, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs, CT, 06269-4026, USA
| | - Angela R Starkweather
- School of Nursing, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs, CT, 06269-4026, USA
| | - Xiaomei S Cong
- School of Nursing, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs, CT, 06269-4026, USA.
- Biobehavioral Research Laboratory, School of Nursing, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs, CT, 06269-4026, USA.
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A neuropsychosocial signature predicts longitudinal symptom changes in women with irritable bowel syndrome. Mol Psychiatry 2022; 27:1774-1791. [PMID: 34819635 PMCID: PMC9095468 DOI: 10.1038/s41380-021-01375-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/09/2022]
Abstract
Irritable bowel syndrome (IBS) is a common disorder of brain-gut interactions characterized by chronic abdominal pain, altered bowel movements, often accompanied by somatic and psychiatric comorbidities. We aimed to test the hypothesis that a baseline phenotype composed of multi-modal neuroimaging and clinical features predicts clinical improvement on the IBS Symptom Severity Scale (IBS-SSS) at 3 and 12 months without any targeted intervention. Female participants (N = 60) were identified as "improvers" (50-point decrease on IBS-SSS from baseline) or "non-improvers." Data integration analysis using latent components (DIABLO) was applied to a training and test dataset to determine whether a limited number of sets of multiple correlated baseline'omics data types, including brain morphometry, anatomical connectivity, resting-state functional connectivity, and clinical features could accurately predict improver status. The derived predictive models predicted improvement status at 3-months and 12-months with 91% and 83% accuracy, respectively. Across both time points, non-improvers were classified as having greater correlated morphometry, anatomical connectivity and resting-state functional connectivity characteristics within salience and sensorimotor networks associated with greater pain unpleasantness, but lower default mode network integrity and connectivity. This suggests that non-improvers have a greater engagement of attentional systems to perseverate on painful visceral stimuli, predicting IBS exacerbation. The ability of baseline multimodal brain-clinical signatures to predict symptom trajectories may have implications in guiding integrative treatment in the age of precision medicine, such as treatments targeted at changing attentional systems such as mindfulness or cognitive behavioral therapy.
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Louwies T, Orock A, Greenwood-Van Meerveld B. Stress-induced visceral pain in female rats is associated with epigenetic remodeling in the central nucleus of the amygdala. Neurobiol Stress 2021; 15:100386. [PMID: 34584907 PMCID: PMC8456109 DOI: 10.1016/j.ynstr.2021.100386] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/23/2021] [Accepted: 08/28/2021] [Indexed: 12/19/2022] Open
Abstract
Stress and anxiety contribute to the pathophysiology of irritable bowel syndrome (IBS), a female-predominant disorder of the gut-brain axis, characterized by abdominal pain due to heightened visceral sensitivity. In the current study, we aimed to evaluate in female rats whether epigenetic remodeling in the limbic brain, specifically in the central nucleus of the amygdala (CeA), is a contributing factor in stress-induced visceral hypersensitivity. Our results showed that 1 h exposure to water avoidance stress (WAS) for 7 consecutive days decreased histone acetylation at the GR promoter and increased histone acetylation at the CRH promoter in the CeA. Changes in histone acetylation were mediated by the histone deacetylase (HDAC) SIRT-6 and the histone acetyltransferase CBP, respectively. Administration of the HDAC inhibitor trichostatin A (TSA) into the CeA prevented stress-induced visceral hypersensitivity through blockade of SIRT-6 mediated histone acetylation at the GR promoter. In addition, HDAC inhibition within the CeA prevented stress-induced histone acetylation of the CRH promoter. Our results suggest that, in females, epigenetic modifications in the limbic brain regulating GR and CRH expression contribute to stress-induced visceral hypersensitivity and offer a potential explanation of how stress can trigger symptoms in IBS patients.
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Affiliation(s)
- Tijs Louwies
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Albert Orock
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Beverley Greenwood-Van Meerveld
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma City VA Medical Center, Oklahoma City, OK, USA
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Aguilera-Lizarraga J, Florens M, Hussein H, Boeckxstaens G. Local immune response as novel disease mechanism underlying abdominal pain in patients with irritable bowel syndrome. Acta Clin Belg 2021; 77:889-896. [PMID: 34709996 DOI: 10.1080/17843286.2021.1996069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder, with a prevalence of up to 25% of the global population. IBS patients suffer from abnormal abdominal pain, or visceral hypersensitivity (VHS), associated with altered bowel habits in the absence of an organic detectable cause. The pathophysiology of the disease is incompletely understood, but the dysregulation of the brain-gut axis is well established in IBS. METHODS IBS onset is mainly triggered by infectious gastroenteritis, psychological factors, and dietary factors, but genetic predispositions and intestinal dysbiosis might also play a role. Additionally, immune activation, and particularly chronic mast cell activation, have been shown to underlie the development of abdominal pain in IBS. RESULTS By releasing increased levels of mediators, including histamine, mast cells sensitize enteric nociceptors and lead to VHS development. The mechanisms underlying aberrant mast cell activation in IBS are still under investigation, but we recently showed that a local break in oral tolerance to food antigens led to IgE-mediated mast cell activation and food-induced abdominal pain in preclinical models and in IBS patients. CONCLUSION The concept of food-mediated VHS highlights the potential of therapies targeting upstream mechanisms of mast cell sensitization to treat IBS.
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Affiliation(s)
- J. Aguilera-Lizarraga
- Center of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Belgium
| | - M. Florens
- Center of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Belgium
| | - H. Hussein
- Center of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Belgium
| | - G. Boeckxstaens
- Center of Intestinal Neuro-immune Interaction, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Belgium
- Department of Gastroenterology & Hepatology, UZ Leuven, Leuven, Belgium
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Buselli R, Veltri A, Corsi M, Marino R, Necciari G, Baldanzi S, Chiumiento M, Del Lupo E, Foddis R, Caldi F, Lambiase C, Pancetti A, Marchi S, Guglielmi G, Bellini M. Irritable Bowel Syndrome prevalence and work ability in a sample of healthcare workers exposed to occupational stress. J Psychosom Res 2021; 148:110566. [PMID: 34246982 DOI: 10.1016/j.jpsychores.2021.110566] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Occupational stress represents a significant precipitating factor in different diseases but its role in Irritable Bowel Syndrome (IBS) needs to be clarified. The present cross-sectional study aimed at investigating the prevalence of IBS diagnosis in a sample of health workers and exploring the potential relationships between IBS, work-related stress levels and work ability. METHODS 653 health workers undergoing periodical occupational health surveillance at the Occupational and Preventive Medicine Unit of a major University Hospital in central Italy, were consecutively recruited and screened for IBS diagnosis, according to ROMA IV criteria. The rating scales IBS Severity Scoring System (IBS-SSS), Demand-Control-Support Questionnaire (DCSQ) and Work Ability Index (WAI) were used to assess respectively IBS severity, occupational stress and work ability levels. RESULTS IBS prevalence in the sample was 16.8%. Participants suffering from IBS were characterized by a higher prevalence of psychiatric diagnosis and sleep disturbances, higher levels of job strain and isostrain as well as by lower levels of work ability compared to non affected subjects. Moreover, the severity of IBS correlated positively with occupational stress and both were negatively associated with work ability. CONCLUSIONS The present results suggest the need for preventive, organizational and management strategies at workplace aimed at protecting the health and well-being but also productivity of the worker with IBS.
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Affiliation(s)
- Rodolfo Buselli
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Antonello Veltri
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
| | - Martina Corsi
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Riccardo Marino
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Gabriele Necciari
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Sigrid Baldanzi
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Martina Chiumiento
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Elena Del Lupo
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Rudy Foddis
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Fabrizio Caldi
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Christian Lambiase
- Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Andrea Pancetti
- Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Santino Marchi
- Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Guglielmi
- Occupational and Preventive Medicine Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Massimo Bellini
- Gastrointestinal Unit, Department of Translational Sciences and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Gros M, Gros B, Mesonero JE, Latorre E. Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management. J Clin Med 2021; 10:jcm10153429. [PMID: 34362210 PMCID: PMC8347293 DOI: 10.3390/jcm10153429] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose aetiology is still unknown. Most hypotheses point out the gut-brain axis as a key factor for IBS. The axis is composed of different anatomic and functional structures intercommunicated through neurotransmitters. However, the implications of key neurotransmitters such as norepinephrine, serotonin, glutamate, GABA or acetylcholine in IBS are poorly studied. The aim of this review is to evaluate the current evidence about neurotransmitter dysfunction in IBS and explore the potential therapeutic approaches. IBS patients with altered colorectal motility show augmented norepinephrine and acetylcholine levels in plasma and an increased sensitivity of central serotonin receptors. A decrease of colonic mucosal serotonin transporter and a downregulation of α2 adrenoceptors are also correlated with visceral hypersensitivity and an increase of 5-hydroxyindole acetic acid levels, enhanced expression of high affinity choline transporter and lower levels of GABA. Given these neurotransmitter dysfunctions, novel pharmacological approaches such as 5-HT3 receptor antagonists and 5-HT4 receptor agonists are being explored for IBS management, for their antiemetic and prokinetic effects. GABA-analogous medications are being considered to reduce visceral pain. Moreover, agonists and antagonists of muscarinic receptors are under clinical trials. Targeting neurotransmitter dysfunction could provide promising new approaches for IBS management.
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Affiliation(s)
- Mónica Gros
- Centro de Salud Univérsitas, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain;
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain; (B.G.); (J.E.M.)
| | - Belén Gros
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain; (B.G.); (J.E.M.)
- Servicio de Urgencias, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
| | - José Emilio Mesonero
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain; (B.G.); (J.E.M.)
- Departamento de Farmacología, Fisiología y Medicina Legal y Forense, Facultad de Veterinaria, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón—IA2—(Universidad de Zaragoza—CITA), 50013 Zaragoza, Spain
| | - Eva Latorre
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain; (B.G.); (J.E.M.)
- Instituto Agroalimentario de Aragón—IA2—(Universidad de Zaragoza—CITA), 50013 Zaragoza, Spain
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Correspondence:
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Impact of Psychological Comorbidity on the Prognosis of Irritable Bowel Syndrome. Am J Gastroenterol 2021; 116:1485-1494. [PMID: 33840729 DOI: 10.14309/ajg.0000000000001247] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/26/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Psychological comorbidities are associated with irritable bowel syndrome (IBS), but little is known about their cumulative effect on its prognosis. We examined this issue in a longitudinal 12-month follow-up study. METHODS We collected complete demographic, symptom, and psychological comorbidity data (anxiety, depression, somatic symptom disorder, perceived stress, and gastrointestinal symptom-specific anxiety) at baseline from 807 adults who met Rome IV criteria for IBS. At 12 months, we collected data regarding IBS symptom severity and impact, consultation behavior, and treatments commenced from 452 individuals successfully followed up. We examined the cumulative effects of psychological comorbidities at baseline on subsequent IBS disease behavior. RESULTS At baseline, among the 807 participants, 177 (21.9%) had 1, 139 (17.2%) 2, 103 (12.8%) 3, 89 (11.0%) 4, and 54 (6.7%) 5 psychological comorbidities. IBS symptom severity at baseline increased significantly with the number of psychological comorbidities (72.2% of those with 5 psychological comorbidities reported severe symptoms, vs 29.1% of those with none, P < 0.001). Among 452 (56.0%) participants followed up at 12 months, those with a higher number of psychological comorbidities at baseline were significantly more likely to have seen a gastroenterologist (33.3% of those with 5 psychological comorbidities, vs 21.4% of those with none, P = 0.001), cycle through more treatments (P < 0.0001), to report more severe IBS symptoms (66.7% with 5, vs 24.4% with none, P < 0.001) and continuous abdominal pain (22.1% with none, vs 61.9% with 5, P < 0.001), and to report that symptoms impacted on daily activities ≥50% of the time (90.5% with 5, vs 41.2% with none, P < 0.001). DISCUSSION The prognosis of individuals with Rome IV-defined IBS worsens according to incremental increases in psychological comorbidity. This has important clinical and research implications.
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Walsh S, Jones M, Gray RJ, Gillam M, Gunn KM, Barker T, Eshetie T, Moseley GL. Use of behavioural activation to manage pain: a scoping review protocol. BMJ Open 2021; 11:e041036. [PMID: 34083325 PMCID: PMC8183225 DOI: 10.1136/bmjopen-2020-041036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 05/06/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Chronic pain is a distressing condition and often poorly treated and managed. Psychological therapies are considered first-line intervention for people with chronic pain. Common psychological therapies require extensive clinician training and specialist qualifications. One approach that does not need lengthy training nor specialist qualification, but has empirical support in other health domains, is behavioural activation (BA). BA seeks to increase engagement in behaviours that are valued by the person and progress through behaviours that can increase mood and develop skills that build satisfying routines. BA can help people to manage their condition through scheduling behaviours, promoting routine and mastery over their condition. The extent to which BA has been used to support people living with chronic pain is not clear. METHODS AND ANALYSIS This scoping review aims to identify published studies describing the application of BA to support people living with chronic pain. To map the evidence regarding BA and chronic pain, including the study type and the associated evidence, a scoping review was adopted. The search will be conducted in bibliographic databases, clinical trial registries and grey literature. No date limits will be applied to the search strategy. Screening of titles and abstracts, and full-text screening, will be independently undertaken by two investigators using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Data from included publications will be extracted using a customised data extraction tool. ETHICS AND DISSEMINATION The scoping review is an analysis of existing data and therefore ethics approval is not required. The findings of this scoping review will further our understanding of how BA has been used to support people living with chronic pain and inform future training and education programmes in this area.
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Affiliation(s)
- Sandra Walsh
- Department of Rural Health, University of South Australian - Whyalla Campus, Whyalla Norrie, South Australia, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Richard John Gray
- School of Nursing, La Trobe University, Bundoora, Victoria, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Mt Barker, South Australia, Australia
| | - Kate M Gunn
- Cancer Research Institute, University of South Australia, Adelaide, South Australia, Australia
| | - Trevor Barker
- Allied Health & Human Performance, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - Tesfahun Eshetie
- Department of Rural Health, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia
| | - G Lorimer Moseley
- Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
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40
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Umrani S, Jamshed W, Rizwan A. Association Between Psychological Disorders and Irritable Bowel Syndrome. Cureus 2021; 13:e14513. [PMID: 34007764 PMCID: PMC8121199 DOI: 10.7759/cureus.14513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction Irritable bowel syndrome (IBS) is an idiopathic, functional and chronic relapsing disorder. Physiological and psychological variables have been linked with etiology of IBS. In this study, we will determine the prevalence of IBS in local setting and its association with anxiety and depression. Materials and methods This cross-section study was conducted in multiple cities of Pakistan. One thousand and seven hundred and sixty (1,760) participants from general population between the age group 18 to 50 were enrolled in the study after informed consent. Diagnosis of IBS was made by assessing participants via ROME III criteria. Hospital anxiety and depression scale (HADS) was used to determine if the participants had anxiety and depression. Results IBS was present in 456 (25.9%) participants. IBS was significantly more prevalent in females compared to males. Anxiety was significantly more common in participants with IBS compared to participants without IBS (53.0% vs. 23.0%; p-value < 0.00001). Similarly, depression was significantly more common in participants with IBS (50.6% vs. 21.5%; p-value < 0.00001). Conclusion IBS is very common in Pakistan, but rarely diagnosed. It is important anyone, particularly at young age, presenting with diarrhea or constipation should be evaluated for IBS. Simultaneously, patients diagnosed with IBS should be screened for anxiety and depression, and managed accordingly.
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Affiliation(s)
- Salman Umrani
- Internal Medicine, University Hospital of North Tees, Stockton-on-Tees, GBR
| | - Waleed Jamshed
- Internal Medicine, Central Park Medical College, Lahore, PAK
| | - Amber Rizwan
- Family Medicine, Jinnah Post Graduate Medical Center, Karachi, PAK
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Ao W, Cheng Y, Chen M, Wei F, Yang G, An Y, Mao F, Zhu X, Mao G. Intrinsic brain abnormalities of irritable bowel syndrome with diarrhea: a preliminary resting-state functional magnetic resonance imaging study. BMC Med Imaging 2021; 21:4. [PMID: 33407222 PMCID: PMC7788841 DOI: 10.1186/s12880-020-00541-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/22/2020] [Indexed: 02/08/2023] Open
Abstract
Background The aim of the present study was to explore the brain active characteristics of patients with irritable bowel syndrome with diarrhea (IBS-D) using resting-state functional magnetic resonance imaging technology. Methods Thirteen IBS-D patients and fourteen healthy controls (HC) were enrolled. All subjects underwent head MRI examination during resting state. A voxel-based analysis of fractional amplitude of low frequency fluctuation (fALFF) maps between IBS-D and HC was performed using a two-sample t-test. The relationship between the fALFF values in abnormal brain regions and the scores of Symptom Severity Scale (IBS-SSS) were analyzed using Pearson correlation analysis. Results Compared with HC, IBS-D patients had lower fALFF values in the left medial superior frontal gyrus and higher fALFF values in the left hippocampus and right precuneus. There was a positive correlation between the duration scores of IBS-SSS and fALFF values in the right precuneus. Conclusion The altered fALFF values in the medial superior frontal gyri, left hippocampus and right precuneus revealed changes of intrinsic neuronal activity, further revealing the abnormality of gut-brain axis of IBS-D.
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Affiliation(s)
- Weiqun Ao
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Yougen Cheng
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Mingxian Chen
- Department of Gastroenterology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Fuquan Wei
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Guangzhao Yang
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Yongyu An
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Fan Mao
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Xiandi Zhu
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China
| | - Guoqun Mao
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang Province, China.
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Cojocariu RO, Balmus IM, Lefter R, Hritcu L, Ababei DC, Ciobica A, Copaci S, Mot SEL, Copolovici L, Copolovici DM, Jurcoane S. Camelina sativa Methanolic and Ethanolic Extract Potential in Alleviating Oxidative Stress, Memory Deficits, and Affective Impairments in Stress Exposure-Based Irritable Bowel Syndrome Mouse Models. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:9510305. [PMID: 33425222 PMCID: PMC7775143 DOI: 10.1155/2020/9510305] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022]
Abstract
Camelina sativa is mainly used as an oilseed crop; its edible oil is being also used as a traditional home remedy for the treatment of ulcers, wounds, and eye inflammations, due to the antioxidant activities. In the present study, the chemically characterized alcoholic extracts of Camelina sativa var. Madalina defatted seeds (5 g/kg body weight p.o., suspended in CMC-Na 0.1%) were administered to stress-induced animal models of irritable bowel syndrome (based on combinations of contention stress and multifactorial stress and maternal stress) and evaluated for the behavioural (short-term memory by the Y maze test, the anxious behaviour using the elevated plus maze test, and the antidepressant effect using the forced swimming test) and brain and bowel tissue oxidative status (superoxide dismutase and glutathione peroxidase enzymes activities and malondialdehyde and total soluble protein levels) improving effects. According to the chemical characterization, the extracts were rich in sinapine, glucosinolates, and flavonol glycosides. Moreover, this study showed the beneficial effects of Camelina sativa seed methanolic and ethanolic extracts on the behaviour and brain and bowel tissues oxidative stress status of stress exposure-based IBS mouse models. Despite the slight differences in the chemical composition of the methanolic and ethanolic extracts, the results suggested that the Camelina sativa extracts could reverse the short-term memory impairments caused by stress exposure and also could decrease the intensity and frequency of the anxiety and depressive-like behaviours observed in the stress-exposed animal models of IBS. Furthermore, the Camelina sativa extracts showed a significant effect on the oxidative stress markers in the brain and bowel tissues of the studied animal model by decreasing the superoxide dismutase activity and increasing the glutathione peroxidase activity. However, the results suggested that the extracts could also increase lipid peroxidation in bowel tissues. In this way, this study provides additional evidence that the administration of Camelina sativa seed alcoholic extracts could improve cognitive performances and mood and exhibit the antioxidant capacity in both the brain and bowel tissues.
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Affiliation(s)
- Roxana O. Cojocariu
- Department of Research, Faculty of Biology, Alexandru Ioan Cuza University, B-dul Carol I, No. 11 Iasi, Romania
| | - Ioana-Miruna Balmus
- Department of Research, Faculty of Biology, Alexandru Ioan Cuza University, B-dul Carol I, No. 11 Iasi, Romania
- Department of Interdisciplinary Research in Science, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, No. 11, Iasi 700506, Romania
| | - Radu Lefter
- Romanian Academy, Center of Biomedical Research, B-dul Carol I, No. 8 Iasi, Romania
| | - Luminita Hritcu
- Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine “Ion Ionescu de la Brad” of Iasi, 3rd Mihail Sadoveanu Alley Iasi 700490, Romania
| | - Daniela C. Ababei
- “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, No. 16, 700115 Iasi, Romania
| | - Alin Ciobica
- Department of Research, Faculty of Biology, Alexandru Ioan Cuza University, B-dul Carol I, No. 11 Iasi, Romania
| | - Simona Copaci
- Faculty of Biotechnology, University of Agronomic Sciences and Veterinary Medicine from Bucharest, Bd. Marasti, No. 59, 011464 Bucharest, Romania
| | - Silvia E. L. Mot
- Doctoral School of Biomedical Sciences, University of Oradea, Universității Str., No 1, 410087 Oradea, Romania
| | - Lucian Copolovici
- Faculty of Food Engineering, Tourism and Environmental Protection; Institute for Research, Development and Innovation in Technical and Natural Sciences, “Aurel Vlaicu” University of Arad, Elena Dragoi St. no 2, 310330 Arad, Romania
| | - Dana M. Copolovici
- Faculty of Food Engineering, Tourism and Environmental Protection; Institute for Research, Development and Innovation in Technical and Natural Sciences, “Aurel Vlaicu” University of Arad, Elena Dragoi St. no 2, 310330 Arad, Romania
| | - Stefana Jurcoane
- Faculty of Biotechnology, University of Agronomic Sciences and Veterinary Medicine from Bucharest, Bd. Marasti, No. 59, 011464 Bucharest, Romania
- Academy of Romanian Scientists, Splaiul Independentei, No 54, Sector 5, 050094 Bucharest, Romania
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Li C, Shuai Y, Zhou X, Chen H. Association between Helicobacter pylori infection and irritable bowel syndrome: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22975. [PMID: 33327230 PMCID: PMC7738067 DOI: 10.1097/md.0000000000022975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In recent years, the incidence of IBS has gradually increased, and it is considered as one of the most common functional gastrointestinal diseases. However, the etiology of IBS is still unclear, and expectations are rising for more targeted treatments. Many clinical trials have explored the link between Helicobacter pylori (H pylori) and IBS, with different conclusions. Therefore, we conducted a meta-analysis to explore whether there is an association between H pylori and IBS, which is of great significance for targeted treatment of IBS. METHODS We performed a systematic review and meta-analysis of the association between H pylori and IBS. We searched PubMed, EMBASE, Medline and the Cochrane Library to collect related studies. OR was used to describe the ratio of the probability of the H pylori infection occurring in IBS patients versus the controls. Heterogeneity was assessed by subgroup and meta-regression analysis. RESULTS Eight studies, including 1861 patients, assessed the association between H pylori infection and IBS. The OR of H pylori in IBS patients compared to controls was 1.32 (95% CI: 0.94-1.87; P = 0.11). Subgroup analyses showed a difference between IBS patients diagnosed with Roman III criteria and those diagnosed with non-Roman III criteria. CONCLUSIONS Our study suggests that H pylori may have a positive effect on the development of IBS. Although the differences were not statistically significant, there were significant differences among subgroups of patients. Considering the limitations and heterogeneity, high quality studies are needed to further explore the effect of H pylori on the development of IBS.
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Affiliation(s)
- Chenyu Li
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Road, Donghu District, Nanchang, Jiangxi Province
- First Clinical Medical College, Nanchang University, Nanchang, China
| | - Yujun Shuai
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Road, Donghu District, Nanchang, Jiangxi Province
- First Clinical Medical College, Nanchang University, Nanchang, China
| | - Xiaodong Zhou
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Road, Donghu District, Nanchang, Jiangxi Province
| | - Hongxia Chen
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Nanchang University
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Peripheral Corticotropin-Releasing Factor Triggers Jejunal Mast Cell Activation and Abdominal Pain in Patients With Diarrhea-Predominant Irritable Bowel Syndrome. Am J Gastroenterol 2020; 115:2047-2059. [PMID: 32740086 DOI: 10.14309/ajg.0000000000000789] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION To determine the effect of peripheral CRF on intestinal barrier function in diarrhea-predominant IBS (IBS-D). Irritable bowel syndrome (IBS) pathophysiology has been linked to life stress, epithelial barrier dysfunction, and mast cell activation. Corticotropin-releasing factor (CRF) is a major mediator of stress responses in the gastrointestinal tract, yet its role on IBS mucosal function remains largely unknown. METHODS Intestinal response to sequential i.v. 5-mL saline solution (placebo) and CRF (100 μg) was evaluated in 21 IBS-D and 17 healthy subjects (HSs). A 20-cm jejunal segment was perfused with an isosmotic solution and effluents collected at baseline, 30 minutes after placebo, and 60 minutes after CRF. We measured water flux, albumin output, tryptase release, stress hormones, cardiovascular and psychological responses, and abdominal pain. A jejunal biopsy was obtained for CRF receptor expression assessment. RESULTS Water flux did not change after placebo in IBS-D and HS but significantly increased after CRF in IBS-D (P = 0.007). Basal luminal output of albumin was higher in IBS-D and increased further after CRF in IBS-D (P = 0.042). Basal jejunal tryptase release was higher in IBS-D, and CRF significantly increased it in both groups (P = 0.004), the response being higher in IBS-D than in HS (P = 0.0023). Abdominal pain worsened only in IBS-D after CRF and correlated with jejunal tryptase release, water flux, and albumin output. IBS-D displayed jejunal up-regulation of CRF2 and down-regulation of CRF1 compared with HS. DISCUSSION Stress via CRF-driven mast cell activation seems to be relevant in the pathophysiology of IBS-D.
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Pemberton L, Kita L, Andrews K. Practitioners' experiences of using Gut Directed Hypnosis for irritable bowel syndrome: Perceived impact upon client wellbeing: A qualitative study. Complement Ther Med 2020; 55:102605. [PMID: 33220622 DOI: 10.1016/j.ctim.2020.102605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/26/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022] Open
Abstract
Gut Directed Hypnosis (GDH) is a specialised form of hypnotherapy originally developed to reduce gastrointestinal (GI) symptoms in individuals with Irritable Bowel Syndrome (IBS). IBS is a condition characterised by symptoms including bloating, abdominal pain and diarrhoea and/or constipation as well as psychosocial symptoms such as depression and anxiety. Although the specific mechanism of action remains unclear, it is suggested that GDH works on the brain-gut axis to improve GI symptoms, psychological functioning and overall wellbeing. The present study aimed to expand upon the knowledge surrounding GDH by exploring practitioners' experiences of using GDH for IBS and their perceptions of how it impacts upon client wellbeing. Six practitioners trained in GDH participated in one hour semi-structured interviews. Thematic Analyses (TA) was used to analyse data. Three major themes emerged from data including: predisposing personality traits and vulnerabilities associated with IBS; GDH as evidence-based practice; and the future evolution of GDH. The findings from this study add to the growing body of literature exploring the use of GDH for IBS, by incorporating the perspective of practitioners working within this field.
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Affiliation(s)
| | - Lauren Kita
- Australian College of Applied Psychology, Australia
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Palsson OS, Ballou S. Hypnosis and Cognitive Behavioral Therapies for the Management of Gastrointestinal Disorders. Curr Gastroenterol Rep 2020; 22:31. [PMID: 32495233 DOI: 10.1007/s11894-020-00769-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE OF REVIEW To review the nature, current evidence of efficacy, recent developments, and future prospects for cognitive behavioral therapy (CBT) and gut-directed hypnotherapy, the two best established psychological interventions for managing gastrointestinal (GI) disorders. RECENT FINDINGS New large randomized controlled trials are showing that cost-effective therapy delivery formats (telephone-based, Internet-based, fewer therapist sessions, or group therapy) are effective for treating GI disorders. CBT and hypnotherapy can produce substantial improvement in the digestive tract symptoms, psychological well-being, and quality of life of GI patients. However, they have long been hampered by limited scalability and significant cost, and only been sufficiently tested for a few GI health problems. Through adoption of more cost-effective therapy formats and teletherapy, and by expanding the scope of efficacy testing to additional GI treatment targets, these interventions have the potential to become widely available options for improving clinical outcomes for patients with hard-to-treat GI disorders.
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Affiliation(s)
- Olafur S Palsson
- Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, P.O. Box 9126, Chapel Hill, NC, 27515, USA.
| | - Sarah Ballou
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Balmus IM, Ilie-Dumitru O, Ciobica A, Cojocariu RO, Stanciu C, Trifan A, Cimpeanu M, Cimpeanu C, Gorgan L. Irritable Bowel Syndrome between Molecular Approach and Clinical Expertise-Searching for Gap Fillers in the Oxidative Stress Way of Thinking. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:38. [PMID: 31963795 PMCID: PMC7023055 DOI: 10.3390/medicina56010038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 02/05/2023]
Abstract
Irritable bowel syndrome (IBS) remains to date an intriguing functional gastrointestinal disorder. Recent studies described a multitude of exogenous factors that work together in IBS, gradually impairing intestinal lining cellular metabolism, including oxidative status balance, with or without a genetic background. Although the current biomarkers support the differentiation between IBS subtypes and other functional gastrointestinal disorder, they are mostly non-specific, referring to clinical, biochemical, and inflammatory imbalances. Since IBS could be also the result of deficient signaling pathways involving both gastrointestinal secretion and neuro-vegetative stimulation, IBS makes no exception from the oxidative hypothesis in the pathological mechanisms. Regarding the oxidative stress implication in IBS, the previous research efforts showed controversial results, with some animal models and patient studies reporting clear oxidative imbalance both on systemic and local levels, but still with no concrete evidence to point to a direct correlation between oxidative stress and IBS. Additionally, it seems that a major role could be also attributed to gut microbiota and their ability to shape our bodies and behaviors. Moreover, the genetic features study in IBS patients showed that several genetic similarities point to a possible correlation of IBS with affective spectrum disorders. Thus, we focus here the discussion on the assumption that IBS could in fact be more likely a stress-related disorder rather than a gastrointestinal one.
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Affiliation(s)
- Ioana-Miruna Balmus
- Department of Interdisciplinary Research in Science, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, No. 11, 700506 Iasi, Romania;
| | - Ovidiu Ilie-Dumitru
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Alin Ciobica
- Department of Research, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania
| | - Roxana-Oana Cojocariu
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Carol Stanciu
- Center of Biomedical Research, Romanian Academy, 8th Carol I Avenue, 700506 Iasi, Romania;
| | - Anca Trifan
- Department of Gastroenterology, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 16th University Street, 700115 Iasi, Romania
| | - Mirela Cimpeanu
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Cristian Cimpeanu
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Lucian Gorgan
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
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Abstract
Irritable bowel syndrome (IBS) is a chronic functional disorder with no organic cause. Risk factors are multifactorial and treatment typically consists of antimotility or stimulant laxatives and antidepressants. This article reviews several newer areas of interest: probiotics, fecal microbiota transplant, a low FODMAP diet, and cognitive behavioral therapy.
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Yanartaş Ö, Kani HT, Kani AS, Akça ZND, Akça E, Ergün S, Tezcan N, Atug Ö, İmeryüz N, Sayar K. Depression and anxiety have unique contributions to somatic complaints in depression, irritable bowel syndrome and inflammatory bowel diseases. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1589177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Ömer Yanartaş
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Haluk Tarik Kani
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Ayşe Sakallı Kani
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | | | - Erdoğdu Akça
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Serhat Ergün
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
| | - Neslihan Tezcan
- Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Özlen Atug
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Neşe İmeryüz
- Department of Gastroenterology, Marmara University School of Medicine, Istanbul, Turkey
| | - Kemal Sayar
- Department of Psychiatry, Marmara University School of Medicine, Istanbul, Turkey
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Keskin G. Approach to stress endocrine response: somatization in the context of gastroenterological symptoms: a systematic review. Afr Health Sci 2019; 19:2537-2545. [PMID: 32127826 PMCID: PMC7040288 DOI: 10.4314/ahs.v19i3.29] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Stress can be defined as an acute threat to the homeostasis of an organism, and in order to manage stress, and maintain stability, the allostatic systems activate an adaptive response. Stress has been shown to have both short - and long-term effects on the function of the gastrointestinal tract, but long-term exposure to stress is more likely to cause endocrine disorders. Objective The aim of this study was to investigate the endocrine response to stress, and evaluate the relationship between somatization and gastrointestinal symptoms. Methods A systematic literature search was conducted on several academic databases, which included, Pubmed, EBSCO and Science Direct. The search was performed using the keywords, “endocrine response to stress”, “somatization” and “gastrointestinal symptoms”. Results The hypothalamic-pituitary-adrenal (HPA) axis is essential in controlling physiological stress responses. Dysfunction is related to several mental disorders, including anxiety and depression, or somatization. Symptoms associated with genetic, or other traumatic experiences of individuals under stress, can lead to a maladaptive response to stress. These stressful life events were found to be associated with digestive system-related chronic diseases. Gastrointestinal disorders significantly affect millions of people worldwide. Conclusion This study examined how the endocrine system responds to stress, and the effect this has in causing stress-related gastrointestinal distresses. Our findings indicate that stress-related psychological disorders are strongly associated with the severity of gastrointestinal symptoms.
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Affiliation(s)
- Gülseren Keskin
- Ege University Atatürk Medical Technological Vocational Training School, İzmir, Turkey
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