Psychometric scores and persistence of irritable bowel after infectious diarrhoea

doi:10.1016/S0140-6736(96)90341-4

The Lancet

Volume 347, Issue 8995, 20 January 1996, Pages 150-153

https://doi.org/10.1016/S0140-6736(96)90341-4 Get rights and content

Abstract

Summary

Background Although previous studies have shown that psychological disturbances are frequently associated with the irritable bowel syndrome (IBS), the relation was not necessarily cause and effect. The development of chronic bowel symptoms resembling IBS after an episode of acute gastroenteritis has allowed us to examine prospectively the role of psychological factors.

Methods 75 patients with acute gastroenteritis completed a series of psychometric tests soon after admission to hospital. Of these, 22 had persistent symptoms compatible with IBS after the acute illness, and in 20 of these the symptoms were still present at six months.

Findings At the time of their initial illness, patients who subsequently developed IBS symptoms had higher scores for anxiety, depression, somatisation, and neurotic trait than those who returned to normal bowel function. The psychometric scores had not changed when remeasured three months after the acute illness. Lactose malabsorption was not an important factor.

Interpretation These results support the hypothesis that psychological factors are important in IBS.

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Citation Excerpt :
This phenomenon may be enhanced by anxiety and depression which alters ANS outflow by increasing catecholamine levels (Lyte, Vulchanova, & Brown, 2011) and increased CRF and cortisol secretion (Keightley, Koloski, & Talley, 2015). Early data have shown, for postinfectious IBS, that at the time of the initial gastroenteritis, patients who had higher scores for anxiety, depression, somatization, and neuroticism were more likely to develop symptom chronicity of IBS (Gwee et al., 1996). Exchange of gut flora between mice can alter both anxiety and expression of BDNF (neurotrophic factor involved in mood regulation) in the brain, and antibiotic treatment in these mice could transiently decrease anxious behavior and BDNF expression if given orally (active on local flora) but not if given intraperitoneally (Bercik et al., 2011).
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Psychometric scores and persistence of irritable bowel after infectious diarrhoea

Abstract

Lancet

J Psychosom Res

Gastroenterology

Lancet

Gastroenterology

Gastroenterology

Gastroenterology

Non-organic gastrointestinal illness: a medical and psychiatric study

Br J Psychiatry

Psychological characteristics of patients with the irritable bowel syndrome

Postgrad Med J

Levels of anxiety in colonic disorders

N Engl J Med

Post-dysenteric colitis

BMJ

The irritable colon

Q J Med

Irritable bowel syndrome-post salmonella infection

J Infection

Functional bowel disease and functional abdominal pain

Gastroenterol Int