Evaluation of Anxiety in Patients with Irritable Bowel Syndrome

Year 2019, , 350 - 355, 20.09.2019

Arzu Bilen Halil Özcan , Ömer Topdağı Habib Bilen

https://doi.org/10.21763/tjfmpc.609949

Abstract

Aim/Background:
Irritable bowel syndrome (IBS) is a frequently encountered health problem in
gastroenterology and primary care practice. The pathophysiology of IBS is still
not fully elucidated. Psychogenic factors may play a significant role in the
emergence and progression of the disease. Anxiety, a widespread psychiatric
sign with many physical symptoms is the most crucial factor in psychogenic
factors of IBS. The aim of this study was to investigate anxiety symptoms in
patients with IBS in daily gastroenterology practice. Method: In our study, 100 patients diagnosed with IBS between 16-75
years of age who admitted to our internal medicine and gastroenterology
outpatient clinics between April 2015 and June 2015 and 70 healthy individuals
between the ages of 16-75 in the control group were included. Patients were
diagnosed according to Rome III criteria. The State-Trait Anxiety Inventory
(STAI) I and II were used. STAI-I was used to measure instant moods and STAI-II
was used to measure perpetual anxiety of the study groups. Results: As a result of our study, anxiety scores were found to be
significantly higher in patients with IBS than in the controls. Conclusion: We believe that our study
is capable of raising awareness on the evaluation of anxiety in patients with
IBS. With this awareness, the evaluation of anxiety symptoms and also the
diagnosis of possible anxiety disorders in IBS patients may come to mind
earlier. Early recognition and treatment of anxiety symptoms possibly
associated with IBS will contribute to IBS treatment in daily gastroenterology
practice.

 

 

Amaç: İrritabl barsak sendromu (IBS) gastroenteroloji ve birinci basamak
uygulamalarında sıkça karşılaşılan bir sağlık sorunudur. IBS patofizyolojisi
hala tam olarak açıklığa kavuşturulmamıştır. Psikojenik faktörler, hastalığın
ortaya çıkmasında ve ilerlemesinde önemli bir rol oynayabilir. Birçok fiziksel
belirtiye sahip ve yaygın bir psikiyatrik bozukluk olan anksiyete, IBS'in
gelişimde önemli faktördür. Bu çalışmanın amacı günlük pratikte
gastroenteroloji polikliniklerinde IBS’ li hastalarda anksiyete semptomlarını
araştırmaktır. Yöntem: Çalışmamızda
Nisan 2015 - Haziran 2015 tarihleri arasında iç hastalıkları ve
gastroenteroloji polikliniğimize başvuran 16-75 yaş arası IBS tanısı alan 100
hasta ile 16-75 yaş arası 70 sağlıklı birey vardı. Roma III kriterlerine göre
hastalar teşhis edildi. Durum Sürekli Kaygı Envanteri (STAI) I ve II
kullanıldı. Çalışma gruplarının anlık duygu durumları ölçmek için STAI-I,
sürekli kaygılarını ölçmek için ise STAI-II kullanılmıştır. Bulgular: Çalışmamız sonucunda IBS
hastalarında kaygı puanları kontrol grubundan anlamlı derecede daha yüksek
bulundu. Sonuç: Çalışmamızın IBS
hastalarında anksiyete değerlendirmesi konusunda farkındalık yaratabildiğine
inanıyoruz. Bu bilinçle, IBS hastalarında anksiyete belirtilerinin
değerlendirilmesi ve olası anksiyete bozukluklarının tanısı daha erken akla
gelebilir. Muhtemelen IBS ile ilişkili anksiyete belirtilerinin erken tanınması
ve tedavisi günlük gastroenteroloji pratiğinde IBS tedavisine katkıda
bulunacaktır.

Keywords

Irritable bowel syndrome, anxiety, psychiatric disorders

References

• 1. Chey WD, Eswaran S, Kurlander J. Irritable Bowel Syndrome. JAMA. 2015; 313(9):982.
• 2. Unal UH. İrritabl Barsak Sendromu.Hakan Ümit ÜNAL Güncel gastroenteroloji. 2012; 16(3).
• 3. Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014 Jun 14; 20(22):6759-73.
• 4. Wald A. Pathophysiology of irritable bowel syndrome. https: // www.uptodate.com / contents / pathophysiology-of-irritable-bowel-syndrome, June 2019.
• 5. Barreau F, Salvador C, Houdeau, Bueno L, Fioramonti J. Long-term alterations of colonic nerve-mast cell interactions induced by neonatal maternal deprivation in rats. Gut 2008; 57: 582-590.
• 6. Bravo JA, Dinan TG, Cryan JF. Alterations in the central CRF system of two different rat models of comorbid depression and functional gastrointestinal disorders. Int J Neuropsychopharmacol 2011; 14: 666-683.
• 7. Hausteiner-Wiehle C, Henningsen P. Irritable bowel syndrome: relations with functional, mental, and somatoform disorders. World journal of gastroenterology: WJG 2014; 20:6024–6030.
• 8. O'Mahony SM, Clarke G, Dinan TG, Cryan JF. Irritable Bowel Syndrome and Stress-Related Psychiatric Co-morbidities: Focus on Early Life Stress. Handb Exp Pharmacol. 2017; 239:219-246.
• 9. Sugaya N, Nomura S, Shimada H. Relationship between cognitive factors and anxiety in individuals with irritable bowel syndrome. Int J Behav Med. 2012 Sep; 19(3):308-15.
• 10. Huerta I, Bonder A, López L, Ocampo MA, Schmulson M. Differences in the stress symptoms rating scale in Spanish between patients with irritable bowel syndrome (IBS) and healthy controls. Rev Gastroenterol Mex. 2002 Jul-Sep; 67(3):161-5.
• 11. Berman S, Suyenobu B, Naliboff BD, Bueller J, Sains J, Wong H et al. Evidence for alterations in central noradrenergic signaling in irritable bowel syndrome. Neuroimage. 2012 Dec; 63(4):1854-63.
• 12. Quek KF, Low WY, Razack AH, Loh CS, Chua CB. Reliability and validity of the Spielberger State-Trait Anxiety Inventory (STAI) among urological patients: A Malaysian study. Med J Malaysia. 2004; 59:258–67.
• 13. Balon R. Rating scales for anxiety/anxiety disorders. Curr Psychiatry Rep. 2007 Aug; 9(4):271-7.
• 14. Mondolo F, Jahanshahi M, Granà A, Biasutti E, Cacciatori E, Di Benedetto P. Evaluation of anxiety in Parkinson's disease with some commonly used rating scales. NeurolSci. 2007 Oct; 28(5):270-5.
• 15. Fond G, Loundou A, Hamdani N, Boukouaci W, Dargel A, Oliveira J et al. Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci. 2014 Dec; 264(8):651-60.
• 16. Lee C, Doo E, Choi JM, Jang SH, Ryu HS, Lee JP et al. The Increased Level of Depression and Anxiety Irritable Bowel Syndrome Patients Compared with Healthy Controls: Systematic Review and Meta-analysis. J Neurogastroenterol Motil. 2017 Jul; 23(3): 349–362.
• 17. Friedrich M, Grady SE, Wall GC. Effects of antidepressants in patients with irritable bowel syndrome and comorbid depression. Clin Ther. 2010 Jul;32(7): 1221-33.
• 18. Jackson JL, O'Malley PG, Kroenke K. Antidepressants and cognitive-behavioral therapy for symptom syndromes. CNS Spectr. 2006 Mar;11(3): 212-22.
• 19. Heitkemper MM, Cain KC, Jarrett ME, Burr RL, Crowell MD, Woods NF et al. Relationship of bloating to other GI and menstrual symptoms in women with irritable bowel syndrome. Dig Dis Sci. 2004 Jan; 49(1):88-95.
• 20. Drossman DA, Chang L, Bellamy N, Gallo-Torres HE, Lembo A, Mearin F et al. Severity in irritable bowel syndrome: a Rome Foundation Working Team report. The American journal of gastroenterology 2011;106:1749–1759.
• 21. Heitkemper MM, Chang L. Do fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome? GendMed. 2009; 6 Suppl 2():152-67.
• 22. Borwin Bandelow, Sophie Michaelis, Epidemiology of anxiety disorders in the 21 st century. Dialogues Clin Neurosci. 2015 Sep; 17(3): 327–335.