martes, 13 de agosto de 2019

Irritable Bowel Syndrome (IBS) and Psychiatric Illness

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By Dr. Ananya Mandal, MDReviewed by April Cashin-Garbutt, MA (Editor)

Most patients with Irritable Bowel Syndrome (IBS) may not meet the criteria for psychological disorders, however, higher rates of this condition are seen among patients with psychiatric illness. This suggests an association or connection between the two conditions.

There is no definitive study that shows that psychiatric disorders precede a diagnosis of irritable bowel syndrome or result as a consequence of it.

Possible mechanisms

Several possible mechanisms that define this association have been speculated upon. For example Britta Dikhaus and colleagues, from UCLA conducted a study where they induced psychological stress by auditory stimuli as well as by distending a balloon cathether within the esophagus of the patients.

The study tested IBS patients whose predominant symptom is diarrhea as well as normal individuals who do not have IBS.

The researchers found that in the IBS patients there was an increased sensitivity and a stronger emotional response compared to the control group. In the control group of normal subjects, this association was not observed.

Treating IBS with antidepressants

The effects of treating IBS with antidepressants have shown success. Antidepressants are also frequently used for a variety of other functional gastrointestinal disorders as well including functional esophageal symptoms, functional dyspepsia, and abdominal pain.

A study by Dr. Ray E. Clouse from the University of Washington, that evaluated several other studies on the effects of antidepressants on functional disorders including IBS showed that the benefits with antidepressants was 4 times higher than placebo pills.

IBS and psychological treatment

Furthermore several psychological treatment interventions have been successfully used in patients with IBS. These include:-

Active psychotherapeutic treatments like:-
- Cognitive Behavioral Therapy
- Dynamic or interpersonal therapy
Passive treatments like:-
- Hypnosis
- Progressive Muscle Relaxation

Cognitive Behavioral Therapy (CBT) involves the patient working with a therapist to address specific perceptions and concerns about their functional gastrointestinal symptoms.