Stress, Anxiety and Functional Gastrointestinal Disorders

Yıl 2012, Cilt: 21 Sayı: 2, 122 - 133, 01.06.2012

Sermin Kesebir Semra Ocak Karataş Çiğdem Bezgin Fatma Cengiz

Öz

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.

Anahtar Kelimeler

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

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