Stres, Anksiyete ve Fonksiyonel Gastrointestinal Bozukluklar

Sermin Kesebir; Semra Ocak Karataş; Çiğdem Bezgin; Fatma Cengiz

EN TR

Stress, Anxiety and Functional Gastrointestinal Disorders

Abstract

Stress has major role in functional gastrointestinal system disorders. The most typical example of this situation is Irritable bowel syndrome. Gastrointestinal system’s response to acute or short-term of stress is delay of gastric emptying and stimulation of colonic transition. While CRF2 receptors are mediate the upper section inhibition, CRF1 is responsible for the lower part colonic and anxiogenic response. Visceral hypersensitivity is managed by the emotional motor system, the amygdala plays a significant role and mucosal mast cells arise. But in people with symptoms of functional gastrointestinal, how is differ motility response in healthy individuals, this situation is due to lack of autonomous nervous system or an increased sensitivity of stress is not adequately understood. The brain-gastrointestinal axis frequency and severity of symptoms associated with negative emotions. American Gastroenterology Association is closely associated with the quality of life and is very difficult to treat the symptoms of gastrointestinal disorders, re-interpreted under the heading of 'Gastrointestinal Distress'. This review is defined as gastrointestinal distresses, physical, emotional, and behavioral components as a disorder in which, almost like an anxiety disorder are discussed. Physical component is pain, gas, and defecation problems, cognitive component is external foci control, catastrophization and anticipatory anxiety, the emotional component is somatic anxiety, hypervigilance, and avoidance of gastrointestinal stimuli as defined.

Keywords

stress, anxiety, gastrointestinal symptoms

Stres, Anksiyete ve Fonksiyonel Gastrointestinal Bozukluklar

Öz

Stresin fonksiyonel gastointestinal sistem bozukluklarında major bir rolü vardır. Bu durumun en tipik örneği irritabl barsak sendromudur. Akut ya da kısa süreli strese gastrointestinal sistem yanıtı, gastrik boşalmanın gecikmesi ve kolonik geçişin uyarılması şeklindedir. CRF2 reseptörleri, üst kısımdaki inhibisyona aracılık ederken, CRF1 alt kısımda kolonik ve anksiyojenik yanıttan sorumludur. Visseral hipersensitivite emosyonel motor sistem tarafından yönetilmekte, en belirgin rolü amigdala oynamakta ve mukozal mast hücrelerinde ortaya çıkmaktadır. Fakat fonksiyonel gastrointestinal yakınmaları olan kişilerde motilite yanıtının, sağlıklı bireylerden nasıl farklılaştığı, bu durumun otonom sinir sistemindeki bir yetersizlikten mi yoksa artmış bir stres duyarlılığından mı kaynaklandığı yeterince anlaşılmış değildir. Beyin-gastrointestinal sistem ekseninde negatif emosyon belirti sıklığı ve şiddeti ile ilişkilidir. Amerikan Gastroentereloglar Birliği, yaşam kalitesi ile yakından ilişkili ve tedavisi oldukça güç olan gastrointestinal bozuklukların belirtilerini, boyutsal olarak bir araya getirmiş, ‘’Gastrointestinal Distres’’ başlığı altında yeniden yorumlamıştır. Bu yorum gastrointestinal distres olarak tanımlanan durumu, fiziksel, emosyonel ve davranışsal bileşenleri olan bir bozukluk olarak, adeta bir anksiyete bozukluğu gibi ele almaktadır. Fiziksel bileşen, ağrı, gaz ve defekasyon sorunları, bilişsel bileşen, dışsal odakların kontrolü, katastrofizasyon ve beklenti anksiyetesi, emosyonel bileşen ise bedensel anksiyete, hipervijilans ve gastrointestinal uyaranlardan kaçınma şeklinde tanımlanmıştır.

Anahtar Kelimeler

Stres, anksiyete, gastrointestinal belirtiler

Kaynakça

McEwen BS. The neurobiology of stress:from serendipity to clinical relevance. Brain Res 2000; 886:172-89.
Yüksel N. Panik bozukluğun nörobiyolojisi. 10. Klinik psikiyatri 2002; 3: 14-21.
Dimsdale JE. Comorbidity studies: a core area for psychosomatic research. Psychosom Med 2001; 63(2):201-2.
Cohen S, Janicki-Deverts D, Miller GE (2007) Psychological stres and disease. JAMA, 298:1685-1687.
Stein MB, Walker JR, Anderson G, Hazen AL, Ross CA, Eldridge G, Forde DR. Childhood physical and sexual abuse in patients with anxiety disorders and in a community sample. Am J Psychiatry 1996; 153(2):275-277.
David D, Giron A, Mellman TA. Panic-phobic patients and developmental trauma. J Clin Psychiatry 1995; 56(3):113-117.
Bandelow B, Charimo Torrente AC, Wedekind D, Broocks A, Hajak G, Rüther E. Early
traumatic life events, parental rearing styles, family history of mental disorders, and birth risk factors in patients with social anxiety disorder. Eur Arch Psychiatry Clin Neurosci 2004; 254(6):397-405.
Kesebir S, Güven S, Baykaran B, Tatlıdil YE, Kılıçarslan EE. Sosyal fobide çocukluk çağı
tarvması ve dissosiyatif belirtiler: Karşılaştırmalı ve Kontrollü bir çalışma. Anksiyete Bozuklukları Kongresi, 2011, Kongre Özet Kitabı, p.33.

Özgen F, Aydın H. Travma sonrası sters bozukluğu. Klinik psikiyatri 1999;1:34-41.
Mönnikes H, Tebbe JJ, Hildebrandt M, Arck P, Osmanoglu E. Role of stres in functional
gastrointestinal disorders. Evidence for stres-induced alterations in gastrointestinal motility and sensivity. Dig Dis 2001; 19:201-211.
Koloski NA, Talley NJ, Boyce PM. Does psychological distress modulate functional gastrointestinal symptoms and health care seeking? A prospective, community Cohort study. Am J Gastroenterol 2003; 98:789-797.
Stengel A, Tache Y. Corticotropin-releasing factor signaling and visceral response to stres. Exp Biol Med 2010; 235:1168-1178.
Drossman DA. Abuse, trauma, and GI illness: is there a link? Am J Gastroenterol 2011; 106:14-25.
O’Mahony SM, Hyland NP, Dinan TG, Cryan JF. Maternal separation as a model of brain-gut
axis dysfunction. Psychopharmacology 2011; 214:71-88.
O’Malley DS, Julio-Pieper M, Gibney SM, Dinan TG, Cryan JF. Distinct alterations in colonic
morphology and physiology in two rat model of enhanced sters-induced anxiety and depression-like behaviour. Stress 2010; 13:114-122.
Fukodo S, Kanazawa M. Gene, enviroment, and brain-gut interactions in irritable bowel syndrome. J Gastroenterol Hepatol 2011; 3: 110-115.
Kilpatrick LA, Labus JS, Coveleskie K, Hammer C, Rappold G, Tillisch K, Bueller JA, Suyenobu B, Jarcho JM, McRoberts JA, Niesler B, Mayer EA. The HTR3A polymorphism c. - 42C>T is associated with amygdala responsiveness in patients with irritable bowel syndrome. Gastroenterology 2011; 140(7):1943-51.
Jansson C, Wallander MA, Johansson S, Johnsen R, Hveem K. Stressful psychosocial factors and symptoms of gastroesophageal reflux disease: a population-based study in Norway. Scand J Gastroenterol. 2010; 45:21-29.
Cain KC, Jarrett ME, Burr RL, Rosen S, Hertig VL, Heitkemper MM. Gender differences in gastrointestinal, psychological, and somatic symptoms in irritable bowel syndrome. Dig Dis Sci. 2009;54(7):1542-9.
Oh JH, Dong MS, Choi MG, Yoo HW, Lee SB, Park YI, Chung IS. Effects of CYP2C19 and MDR1 genotype on the eradication rate of Helicobacter pylori infection by triple therapy with pantoprazole, amoxycillin and clarithromycin. J Gastroenterol Hepatol 2009; 24(2):294-8.
Shi M, Liu D, Duan H, Han C, Wei B, Qian L, Chen C, Guo L, Hu M, Yu M, Song L, Shen B, Guo N. Catecholamine up-regulates MMP-7 expression by activating AP-1 and STAT3 in gastric cancer. Mol Cancer. 2010; 12(9):269-73.
31- Drossman DA, Thompson WG. The irritable bowel syndrome:review and a graduated multicomponent treatment approach. Annals of internal medicine 1992; 12:1009-1016.
Van Oudenhove L, Vandenberghe J, Geeraerts B, Vos R, Persoons P, Fischler B, Demyttenaere K, Tack J. Determinants of symptoms in functional dyspepsia: gastric sensorimotor function, psychosocial factors or somatisation? Gut. 2008; 57(12):1666-73.
Van Oudenhove L, Vandenberghe J, Geeraerts B, Vos R, Persoons P, Demyttenaere K, Fischler B, Tack J. Relationship between anxiety and gastric sensorimotor function in functional dyspepsia. Psychosom Med. 2007; 69(5):455-63.
Burton C, Weller D, Sharpe M. Functional somatic symptoms and psychological states: an electronic diary study. Psychosom Med. 2009; 71(1):77-83.
Burton C, Weller D, Sharpe M. Are electronic diaries useful for symptoms research? A systematic review. J Psychosom Res. 2007; 62(5):553-61.
Eriksen HR, Ursin H. Subjective health complaints, sensitization, and sustained cognitive activation (stres). J Psychosom Res. 2004; 56:445-448.
Ursin H, Eriksen H. Cognitive activation theory of stress, sensitization, and common health complaints. Ann N Y Acad Sci. 2007; 1113:304-10.
Ursin H, Eriksen HR. Cognitive activation theory of stress (CATS). Neurosci Biobehav Rev. 2010; 34(6):877-81.
Mutsuura H, Kanbara K, Fukunaga M, Yamamoto K, Ban I. Depression and anxiety correlate differently with salivary free cortisol in the morning in patients with functional somatic syndrome. Appl Psychophysiol Biofeedback. 2009; 34:291-298.
Rinaldis M, Pakenham KI, Lynch BM, Aitken JF. Development, confirmation, and validation of a measure of coping with kolorectal cancer: a longitudinal investigation. Psychooncology. 2009; 18:624-633.
Ristvedt SL, Trinkaus KM. Trait anxiety as an independent predictor of poor health-related quality of life and post-traumatic stres symptoms in rectal cancer. Br J Health Psychol. 2009; 14:701-715.
Spiegel BM, Khanna D, Bolus R, Agarwal N, Khanna P, Chang L. Understanding gastrointestinal distress: a framework for clinical practice. Am J Gastroenterol. 2011; 106(3):380-5.
Jerndal P, Ringström G, Agerforz P, Karpefors M, Akkermans LM, Bayati A, Simrén M. Gastrointestinal-specific anxiety: an important factor for severity of GI symptoms and quality of life in IBS. Neurogastroenterol Motil. 2010; 22(6):646-E179.
Keough ME, Timpano KR, Zawilinski LL, Schmidt NB. The association between irritable bowel syndrome and the anxiety vulnerability factors: body vigilance and discomfort intolerance. J Health Psychol. 2011; 16(1):91-8.
Elsenbruch S. Abdominal pain in Irritable Bowel Syndrome: a review of putative psychological, neural and neuro-immune mechanisms. Brain Behav Immun. 2011; 25(3):386-94.
Hyphantis TN, Tomenson B, Bai M, Tsianos E, Mavreas V, Creed F. Psychological distress, somatization, and defense mechanisms associated with quality of life in inflammatory bowel disease patients. Dig Dis Sci 2010; 55(3):724-32.
Ljottson B, Andersson G, Andersson E, Hedman E, Lindfors P. Acceptability, effectiveness, and cost-effectiveness of internet-based exposure treatment for irritable bowel syndrome in a clinical sample: a randomized controlled trial. BMC Gastroenterology 2011; 11:110-123.
Chey WD, Mannerattaporn M, Saad R. Pharmacologic and complementary and alternative medicine therapies for irritable bowel syndrome. Gut and Liver 2011; 3:253-266.
Mönnikes H, Heading RC, Schmitt H, Doerfler H. Influence of irritable bowel syndrome on
treatment outcome in gastroesophageal reflux disease. World J Gastroenterol 2011; 17: 3235-3241.

Ayrıntılar

Birincil Dil

Türkçe

Konular

-

Bölüm

-

Yazarlar

Sermin Kesebir Bu kişi benim

Semra Ocak Karataş Bu kişi benim

Çiğdem Bezgin Bu kişi benim

Fatma Cengiz Bu kişi benim

Yayımlanma Tarihi

1 Haziran 2012

Gönderilme Tarihi

30 Ekim 2014

Kabul Tarihi

-

Yayımlandığı Sayı

Yıl 2012 Cilt: 21 Sayı: 2

IZ

https://izlik.org/JA45MF26JE

AMA

1.Kesebir S, Karataş SO, Bezgin Ç, Cengiz F. Stres, Anksiyete ve Fonksiyonel Gastrointestinal Bozukluklar. aktd. 2012;21(2):122-133. https://izlik.org/JA45MF26JE

Stress, Anxiety and Functional Gastrointestinal Disorders

Abstract

Keywords

Stres, Anksiyete ve Fonksiyonel Gastrointestinal Bozukluklar

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

IZ

Kaynak Göster