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Liu T, Wang Z, Kang X, Wang X, Ren G, Lv Y, Li J, Liu Y, Liang S, Nie Y, Luo H, Pan Y. Causal relationships between psychological disorders and functional gastrointestinal disorders: a bidirectional two-sample Mendelian randomization study. Eur J Gastroenterol Hepatol 2024; 36:1267-1274. [PMID: 38973539 DOI: 10.1097/meg.0000000000002825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
BACKGROUND AND AIMS Observational studies have shown bidirectional associations between psychological disorders (e.g. depression and anxiety) and functional gastrointestinal disorders. However, whether the relationships are causal is uncertain. Here, we used a bidirectional two-sample Mendelian randomization method to investigate the association between psychological disorders and functional gastrointestinal disorders (FGIDs). METHODS We obtained genome-wide association study summary statistics for two common psychological disorders: depression (170 756 cases) and anxiety (31 977 cases), as well as for three common FGIDs: functional dyspepsia with 6666 cases, constipation with 26 919 cases, and irritable bowel syndrome (IBS) with 7053 cases. These summary statistics were retrieved from several publicly available genome-wide association study databases. The inverse variance weighted method was used as the main Mendelian randomization method. RESULTS Inverse variance weighted Mendelian randomization analyses showed statistically significant associations between genetically predicted depression and risk of functional dyspepsia [odds ratio (OR): 1.40, 95% confidence interval (CI): 1.08-1.82], constipation (OR: 1.28, 95% CI: 1.13-1.44), and IBS (OR: 1.51, 95% CI: 1.37-1.67). Genetically predicted anxiety was associated with a higher risk of IBS (OR: 1.13, 95% CI: 1.10-1.17) instead of functional dyspepsia and constipation. In addition, genetically predicted IBS instead of functional dyspepsia and constipation was associated with a higher risk of depression (OR: 1.33, 95% CI: 1.12-1.57) and anxiety (OR: 2.05, 95% CI: 1.05-4.03). CONCLUSION Depression is a causal risk factor for three common FGIDs. A bidirectional causal relationship between IBS and anxiety or depression was also identified.
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Affiliation(s)
- Tangyi Liu
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China
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Miyaguchi R, Masuda F, Sumi Y, Kadotani H, Ozeki Y, Banno M, Kuniyoshi Y. Prevalence of depression or depressive state in patients with restless legs syndrome: A systematic review and meta-analysis. Sleep Med Rev 2024; 77:101975. [PMID: 39024776 DOI: 10.1016/j.smrv.2024.101975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 06/19/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
Restless legs syndrome (RLS) is a common sleep-related disorder characterized by limb discomfort and the urge to move them when at rest, especially in the evening or at night. Although depression is often linked to various conditions, no systematic review has assessed depression prevalence in patients with RLS after the latest diagnostic criteria revision. This systematic review and meta-analysis aimed to investigate the depression and depressive state prevalence among patients with RLS. We systematically searched databases up to November 2022 and performed meta-analyses of the depression prevalence using a random-effects model and a meta-regression analysis to explore the relationship between the prevalence and severity of depression and factors such as age and RLS severity. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we analyzed 24 studies with 2039 patients. The pooled depression or depressive state prevalence, mostly defined by questionnaire scores, was 30.39 %. Nine studies reported the proportion of patients taking antidepressants (pooled rate: 3.41 %). No specific factors related to the prevalence or severity of depression were identified in patients with RLS. These findings highlight the significant prevalence of depression and underscore the need for future research with standardized diagnostic interviews and consistent methodologies across multi-site studies.
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Affiliation(s)
- Rin Miyaguchi
- Faculty of Medicine, Shiga University of Medical Science, Shiga, Japan
| | - Fumi Masuda
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan; Department of Psychiatry, Nagahama Red Cross Hospital, Shiga, Japan
| | - Hiroshi Kadotani
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan.
| | - Yuji Ozeki
- Department of Psychiatry, Shiga University of Medical Science, Shiga, Japan
| | - Masahiro Banno
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan; Department of Psychiatry, Seichiryo Hospital, Nagoya, Japan
| | - Yasutaka Kuniyoshi
- Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan; Department of Pediatrics, Tsugaruhoken Medical COOP Kensei Hospital, Aomori, Japan
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Sun Q, Xiong N, Wang Y, Xia Z, Chen J, Yan C, Sun H. Shared and distinct aberrations in frontal-striatal system functional patterns among patients with irritable bowel syndrome and major depressive disorder. J Affect Disord 2024; 362:391-403. [PMID: 38986877 DOI: 10.1016/j.jad.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/09/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Considering the high comorbidity, shared risk factors, and genetic pathways between irritable bowel syndrome (IBS) and major depressive disorder (MDD), we hypothesized that there would be both shared and disorder-specific alterations in brain function. METHODS A total of 39 IBS patients, 39 MDD patients, and 40 healthy controls (HCs) were enrolled and matched for sex, age, and educational level. All subjects underwent resting-state functional MRI. The clinical variables of anxiety, depression, gastrointestinal symptoms and alexithymia were recorded. The 12 subregions of the striatum were employed as seeds to assess their functional connectivity (FC) with every voxel throughout the whole brain. RESULTS Compared to HC, IBS and MDD patients exhibited aberrant frontal-striatal circuitry. We observed a common decrease in FC between the dorsal striatum and regions of the hippocampus, sensorimotor cortex, and prefrontal cortex (PFC) in both IBS and MDD patients. Patients with IBS exhibited disorder-specific decreases in FC within the striatum, along with reduced connectivity between the ventral striatum and sensorimotor cortex. In contrast, MDD patients showed disorder-specific hyperconnectivity in the medial PFC-limbic system. Receiver operating characteristic curve analysis showed that frontal-striatal FC values could serve as transdiagnostic markers of IBS and MDD. Within the IBS group, striatal connectivity was not only negatively associated with weekly abdominal pain days but also negatively correlated with the levels of anxiety and alexithymia. CONCLUSIONS This exploratory analysis indicated that patients with IBS and MDD exhibited both shared and disorder-specific frontal-striatal circuit impairments, potentially explaining both comorbidity and distinct phenotypes.
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Affiliation(s)
- Qiqing Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Nana Xiong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
| | - Yuwei Wang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Zhiwei Xia
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
| | - Jie Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Chaogan Yan
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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Kwon H, Nam EH, Kim H, Jo H, Bang WY, Lee M, Shin H, Kim D, Kim J, Kim H, Lee J, Jung YH, Yang J, Won DD, Shin M. Effect of Lacticaseibacillus rhamnosus IDCC 3201 on irritable bowel syndrome with constipation: a randomized, double-blind, and placebo-controlled trial. Sci Rep 2024; 14:22384. [PMID: 39333245 PMCID: PMC11437119 DOI: 10.1038/s41598-024-72887-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 09/11/2024] [Indexed: 09/29/2024] Open
Abstract
Irritable bowel syndrome is a chronic disorder affecting the gastrointestinal tract, negatively impacting patients' quality of life. Here, we aimed to evaluate the effects of Lacticaseibacillus rhamnosus IDCC 3201 (RH 3201) on irritable bowel syndrome with constipation (IBS-C). In this randomised, double-blind, placebo-controlled trial, a total of 30 subjects with IBS-C were randomly assigned (1:1) to receive 8 weeks of probiotics administration or placebo. Concerning bowel activities, both irritant bowel movements and discomfort caused by constipation showed significant improvement with RH 3201 at 8 weeks. Symptoms including severity of abdominal bloating, frequency of abdominal bloating, and satisfaction of bowel habits based on the irritable bowel syndrome-severity scoring system also ameliorated in the probiotic group. Analysis of the fecal microbiome revealed that the abundance of Bacteroides cellulosilyticus and Akkermansia muciniphila was higher during the period of RH 3201 administration compared to the placebo. Untargeted metabolome analysis further suggested a correlation between specific metabolites, such as N-acetylornithine, xanthine, and 3-phenylpropionic acid, and the improvement of clinical symptoms. These results indicate that RH 3201 was effective in ameliorating IBS-C, potentially by enriching beneficial microbes and associated metabolites in the gut environment.
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Affiliation(s)
- Hyeji Kwon
- Immunology Laboratory, Cancer Genomic Research Institute, Seoul Song Do Colorectal Hospital, Seoul, 04597, Republic of Korea
| | - Eoun Ho Nam
- Department of Microbiology, College of Medicine, Inha University, Incheon, 22212, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, 22212, Republic of Korea
| | - Hayoung Kim
- Ildong Bioscience, Pyeongtaek-si, Gyeonggi-do, 17957, Republic of Korea
| | - Haneul Jo
- Department of Microbiology, College of Medicine, Inha University, Incheon, 22212, Republic of Korea
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, 22212, Republic of Korea
| | - Won Yeong Bang
- Ildong Bioscience, Pyeongtaek-si, Gyeonggi-do, 17957, Republic of Korea
| | - Minjee Lee
- Ildong Bioscience, Pyeongtaek-si, Gyeonggi-do, 17957, Republic of Korea
| | - Hyeonmin Shin
- Immunology Laboratory, Cancer Genomic Research Institute, Seoul Song Do Colorectal Hospital, Seoul, 04597, Republic of Korea
| | - Dana Kim
- Immunology Laboratory, Cancer Genomic Research Institute, Seoul Song Do Colorectal Hospital, Seoul, 04597, Republic of Korea
| | - Jeongho Kim
- Digestive Endoscopic Center, Seoul Song Do Colorectal Hospital, Seoul, 04597, Republic of Korea
| | - Hyejin Kim
- Digestive Endoscopic Center, Seoul Song Do Colorectal Hospital, Seoul, 04597, Republic of Korea
| | - Jongkyun Lee
- Department of Surgery, Pelvic Floor Center, Seoul Song Do Colorectal Hospital, Seoul, 04597, Republic of Korea
| | - Young Hoon Jung
- School of Food Science and Biotechnology, Kyungpook National University, Daegu, 41566, Republic of Korea
- Institute of Fermentation Biotechnology, Kyungpook National University, Daegu, 41566, Republic of Korea
| | - Jungwoo Yang
- Department of Microbiology, Dongguk University College of Medicine, 123 Dongdae-ro, Gyeongju, 38066, Republic of Korea.
| | - Daeyoun David Won
- Department of Surgery, Pelvic Floor Center, Seoul Song Do Colorectal Hospital, Seoul, 04597, Republic of Korea.
| | - Minhye Shin
- Department of Microbiology, College of Medicine, Inha University, Incheon, 22212, Republic of Korea.
- Department of Biomedical Science, Program in Biomedical Science and Engineering, Inha University, Incheon, 22212, Republic of Korea.
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5
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Saini U, Rosmalen JGM, Oldehinkel AJ, van Loo HM. Connecting the dots: Network structures of internalizing and functional symptoms in a population-based cohort. J Psychosom Res 2024; 187:111932. [PMID: 39298869 DOI: 10.1016/j.jpsychores.2024.111932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/22/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVE Comorbidities between internalizing disorders (IDs) and functional disorders (FDs) are well-documented, indicating shared pathways. However, their symptom-level relationships have been largely unexplored. This exploratory study employs a network approach to investigate symptoms of major depressive disorder (MDD), generalized anxiety disorder (GAD), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS) to identify bridge symptoms explaining comorbidity between the two domains. METHODS We used cross-sectional data on 72,919 adult subjects from the Lifelines Cohort Study, a Dutch general population sample. A total of 38 symptoms representing diagnostic criteria of IDs and FDs were assessed with validated questionnaires. Network models were estimated using eLasso, based on the Ising model, to identify bridge symptoms. The Network Comparison Test (NCT) was used to test whether there were differences in network structure and strength across sex and age. RESULTS Symptoms were moderately connected, with a network density of 52.7%. ID and FD symptoms clustered in their respective domains, but were connected through the bridge symptoms, fatigue, difficulty concentrating, trouble sleeping, and unrefreshing sleep. Fatigue and difficulty concentrating had the most connections, associated with 86.6% and 78.9% of the other symptoms, respectively. NCTs indicated no differences in network connectivity between females versus males or younger versus older adults (>50 years). CONCLUSIONS ID and FD symptoms are moderately interconnected. Bridge symptoms displaying strong connections to multiple disorders may play a central role in the mechanisms underpinning the comorbidity between IDs and FDs.
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Affiliation(s)
- Urvi Saini
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands.
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; University Medical Center Groningen, Department of Internal Medicine, Groningen, the Netherlands
| | - Albertine J Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
| | - Hanna M van Loo
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands
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Fan W, Liu YL, Jiang CH, Wu HY, Jin J, He ZX, Kang L, Fang X. Association between psychiatric disorders and irritable bowel syndrome: A bidirectional Mendelian randomization study. J Affect Disord 2024:S0165-0327(24)01515-5. [PMID: 39260576 DOI: 10.1016/j.jad.2024.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/31/2024] [Accepted: 09/08/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE Previous studies have suggested that irritable bowel syndrome (IBS) is strongly associated with psychiatric disorders. However, it is unclear whether this association is causal, concomitant, or accidental. Thus, we performed Mendelian randomization (MR) analysis to evaluate the causal effects of several psychiatric disorders on IBS. METHODS Summary data of genome-wide association studies (GWASs) were obtained mainly from the Psychiatric Genomics Consortium (PGC) on individuals of European ancestry and from a recent GWAS on IBS. We used three MR methods, the inverse-variance weighting (IVW), weighted median (WM), and MR-Egger regression (MR-Egger). In addition, two other indicators, namely, the MR-IVW Cochran's Q statistic and MR-Egger intercept, were used to assess heterogeneity and detect directional horizontal pleiotropy, respectively. RESULTS Heritability was high for bipolar disorder (81.18 %, 95 % CI = 73.18-148.18 %), schizophrenia (33.88 %, 95 % CI = 33.57-38.19 %), and panic disorder (30.66 %, 95 % CI = 20.74-40.58 %). For other disorders, there was a low liability-scale SNP heritability for major depressive disorder (MDD) (0.67 %, 95 % CI = 0.61-0.73 %), anxiety disorder (7.63 %, 95 % CI = 1.67-13.59 %), PTSD (0.96 %, 95 % CI = 0.12-1.8 %), and IBS (2.44 %, 95 % CI = 2.13-2.75 %). We also observed that schizophrenia had a significant causal effect on IBS according to MR-IVW. Notably, the individual causal estimates of genetic instruments for MDD and schizophrenia were heterogeneous, but no pleiotropic effects were observed. CONCLUSIONS Our analyses revealed the causal effects of MDD and schizophrenia on IBS, a matter that has been subject to debate for decades, and also showed that IBS had causal effects on MDD.
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Affiliation(s)
- Wang Fan
- Department of Gastroenterology, Changhai hospital, Naval Medical University, Shanghai 200433, China
| | - Yi-Long Liu
- College of Basic Medicine Sciences, Second Military Medical University/Naval Medical University, Shanghai, China
| | - Chun-Hui Jiang
- Department of Gastroenterology, Changhai hospital, Naval Medical University, Shanghai 200433, China
| | - Hong-Yu Wu
- Department of Gastroenterology, Changhai hospital, Naval Medical University, Shanghai 200433, China
| | - Jing Jin
- Department of Gastroenterology, Changhai hospital, Naval Medical University, Shanghai 200433, China
| | - Zi-Xuan He
- Department of Gastroenterology, Changhai hospital, Naval Medical University, Shanghai 200433, China.
| | - Le Kang
- Department of Gastroenterology, Changhai hospital, Naval Medical University, Shanghai 200433, China.
| | - Xue Fang
- Department of Gastroenterology, Changhai hospital, Naval Medical University, Shanghai 200433, China.
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Lacy BE, Xu Y, Taylor DCA, Kosch KJ, Dobrescu R, Morlock A, Morlock R, Rooker C. Burden of illness and treatment attitudes among participants meeting Rome IV criteria for irritable bowel syndrome: A nationwide survey in the United States. Neurogastroenterol Motil 2024:e14903. [PMID: 39223955 DOI: 10.1111/nmo.14903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 07/02/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by abdominal pain and altered bowel habits, with patient-perceived dissatisfaction of treatment symptom control. We assessed disease burden, satisfaction with medication use, and impact on activities, in participants with IBS with constipation (IBS-C) and diarrhea (IBS-D). METHODS This study assessed data from a large, United States survey of adults querying demographics, comorbid conditions, quality of life, medication use, satisfaction with symptom control, and work productivity. Participants were grouped into the IBS-C or IBS-D cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self-reported. KEY RESULTS Nine hundred and ten participants with IBS-C and 669 with IBS-D were matched to controls. The most reported symptoms were abdominal discomfort for IBS-C and abdominal pain and abdominal discomfort for IBS-D. Among the IBS-C and IBS-D cohorts, 74.2% and 65.9%, respectively, took prescription and/or over-the-counter medication for their symptoms. Respondents were more dissatisfied than satisfied with control of their symptoms. Respondents taking prescription medication(s) with or without over-the-counter medication(s) reported better symptom control than respondents only taking over-the-counter medications (p < 0.001). There was significantly higher mean presenteeism, work productivity loss, and daily activity impairment (p < 0.001 for all) in respondents with IBS compared with controls. CONCLUSIONS AND INFERENCES This study provides insight into respondents' experiences of IBS symptoms, including the impact on daily activity, as well as satisfaction with control of symptoms and prescription and over-the-counter medications.
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Affiliation(s)
- Brian E Lacy
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Yanqing Xu
- AbbVie Inc, North Chicago, Illinois, USA
| | | | | | | | - Amy Morlock
- Acumen Health Research Institute, Ann Arbor, Michigan, USA
| | | | - Ceciel Rooker
- International Foundation for Gastrointestinal Disorders, Milwaukee, Wisconsin, USA
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Huang Y, Zheng E, Hu M, Yang X, Lan Q, Yu Y, Xu B. The impact of depression-mediated gut microbiota composition on Irritable Bowel Syndrome: A Mendelian study. J Affect Disord 2024; 360:15-25. [PMID: 38801922 DOI: 10.1016/j.jad.2024.05.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE This study uses a two-sample Mendelian randomization (MR) analysis to delineate the causal influence of gut microbiota on the occurrence of irritable bowel syndrome (IBS), concurrently assessing the potential mediating function of depression within this framework. METHODS Several two-sample MR methods were used to assess the causal repercussions of gut microbiota on the onset of both IBS and depression. Following this, gut microbiota and depression, which demonstrated notable causal associations, were integrated as exposure variables in a multivariable Mendelian randomization (MVMR) framework to construct a model encompassing gut microbiota, depression, and IBS. Mediation effects were assessed by examining the indirect pathway of gut microbiota → depression → IBS. RESULTS Two-sample MR analysis unveiled a statistically significant causal association (P < 0.05) between specific bacterial group within the gut microbiota, notably p_Actinobacteria(OR = 0.829225), c_Clostridia(OR = 0.798897), s_Desulfovibrio_piger(OR = 1.163912), g_Streptococcus(OR = 1.132735), c_Actinobacteria(OR = 0.829224), and the onset of IBS. In the MVMR analysis, the relationship between depression and IBS was significant across Model 3, Model 7, Model 8, and Model 13 (P < 0.05). Assessment of mediation effects revealed that c_Clostridia and o_Clostridiales indirectly impacted IBS through depression, with masking effect ratios of 168.46 % and 168.44 %, respectively. CONCLUSION These findings underscore a resilient causal association between the composition of gut microbiota and the initiation of IBS. Furthermore, depression serves as a mediator for particular groups of gut bacteria, thereby contributing to the development of IBS. These observations imply that interventions targeting mental health may potentially alleviate the risk of IBS onset attributable to adverse configurations of gut microbiota.
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Affiliation(s)
- Yi Huang
- Department of General Surgery, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang, China
| | - Endian Zheng
- Department of Gastroenterology, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang, China
| | - Mei Hu
- Postgraduate training base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang, China
| | - Xinxin Yang
- Department of Infectious Diseases, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang, China
| | - Qiaoli Lan
- Department of Gastroenterology, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang, China
| | - Yingcong Yu
- Department of Gastroenterology, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang, China.
| | - Beibei Xu
- Department of Gastroenterology, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, The Third Affiliated Hospital of Shanghai University, Wenzhou People's Hospital, Wenzhou 325000, Zhejiang, China.
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Thomas NS, Gillespie NA, Kendler KS, Oldehinkel AJ, Rosmalen JGM, van Loo HM. Comorbidity and sex differences in functional disorders and internalizing disorders. Gen Hosp Psychiatry 2024; 90:91-98. [PMID: 39079424 PMCID: PMC11390307 DOI: 10.1016/j.genhosppsych.2024.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE In the current exploratory study we estimate comorbidity rates between FDs [fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and irritable bowel syndrome (IBS)]-and IDs-[major depressive disorder (MDD) and generalized anxiety disorder (GAD)] by using self-reported diagnostic criteria. METHOD We analyzed data from 107,849 participants (mean age = 49.3 (SD = 13.0), 58.6% women) of the Lifelines Cohort Study. Lifelines is a prospective population-based cohort study in the northeast of the Netherlands. Current IDs were assessed using the Mini-International Neuropsychiatric Interview. Current FM, ME/CFS, and IBS were assessed according to the 2010 American College of Rheumatology criteria, the 1994 Centers for Disease Control and Prevention criteria and the ROME IV criteria, respectively. We estimated tetrachoric correlations between diagnoses and tested for sex differences. Additionally, we estimated the ratio of observed-to-expected frequency for combinations of diagnoses. RESULTS FDs and IDs are highly comorbid (odds ratios: 3.2-12.6) with associations stronger among men. Participants with at least three disorders/diagnoses were more prevalent than expected by chance. CONCLUSION Studies that aim to explain sex differences and the comorbidity of specific combinations of IDs and FDs will be an important contribution to understanding the etiology of these conditions.
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Affiliation(s)
- Nathaniel S Thomas
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Box 980126, Richmond, VA 23298-0126, USA.
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Box 980126, Richmond, VA 23298-0126, USA
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Box 980126, Richmond, VA 23298-0126, USA
| | - Albertine J Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, P.O. Box 30.001, 9700, RB, Groningen, Netherlands
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, P.O. Box 30.001, 9700, RB, Groningen, Netherlands; University of Groningen, University Medical Center Groningen, Department of Internal Medicine, P.O. Box 30.001, 9700, RB, Groningen, Netherlands
| | - Hanna M van Loo
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, P.O. Box 30.001, 9700, RB, Groningen, Netherlands
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10
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Luo M, Liu J, Zhang Z, Tao J, Chen Y, Li X, Zou X, Sun J, Jin J, Wang H, Xiong L. Diagnostic accuracy of a simplified tool for irritable bowel syndrome with predominant constipation in Chinese patients: A multicenter, prospective, observational study. Chin Med J (Engl) 2024:00029330-990000000-01196. [PMID: 39183566 DOI: 10.1097/cm9.0000000000003246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Indexed: 08/27/2024] Open
Affiliation(s)
- Mei Luo
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jinsong Liu
- Division of Gastroenterology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430032 China
| | - Zhe Zhang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110055, China
| | - Jin Tao
- Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510620, China
| | - Youxiang Chen
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330209, China
| | - Xiuling Li
- Department of Gastroenterology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, School of Clinical Medicine, Henan University, Zhengzhou, Henan 540003, China
| | - Xiaoping Zou
- Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, China
| | - Jing Sun
- Department of Gastrointestinal Surgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Minimally Invasive Surgery Clinical Center, Shanghai 200031, China
| | - Jie Jin
- Department of Gastroenterology, Wenzhou Central Hospital, Wenzhou, Zhejiang 325102, China
| | - Huahong Wang
- Department of Gastroenterology, Peking University First Hospital, Beijing 100034, China
| | - Lishou Xiong
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
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11
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Li C, Li J, Zhou Q, Wang C, Hu J, Liu C. Effects of Physical Exercise on the Microbiota in Irritable Bowel Syndrome. Nutrients 2024; 16:2657. [PMID: 39203794 PMCID: PMC11356817 DOI: 10.3390/nu16162657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 08/06/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder characterized by abdominal pain, bloating, diarrhea, and constipation. Recent studies have underscored the significant role of the gut microbiota in the pathogenesis of IBS. Physical exercise, as a non-pharmacological intervention, has been proposed to alleviate IBS symptoms by modulating the gut microbiota. Aerobic exercise, such as running, swimming, and cycling, has been shown to enhance the diversity and abundance of beneficial gut bacteria, including Lactobacillus and Bifidobacterium. These bacteria produce short-chain fatty acids that possess anti-inflammatory properties and support gut barrier integrity. Studies involving IBS patients participating in structured aerobic exercise programs have reported significant improvements in their gut microbiota's composition and diversity, alongside an alleviation of symptoms like abdominal pain and bloating. Additionally, exercise positively influences mental health by reducing stress and improving mood, which can further relieve IBS symptoms via the gut-brain axis. Long-term exercise interventions provide sustained benefits, maintaining the gut microbiota's diversity and stability, supporting immune functions, and reducing systemic inflammation. However, exercise programs must be tailored to individual needs to avoid exacerbating IBS symptoms. Personalized exercise plans starting with low-to-moderate intensity and gradually increasing in intensity can maximize the benefits and minimize risks. This review examines the impact of various types and intensities of physical exercise on the gut microbiota in IBS patients, highlighting the need for further studies to explore optimal exercise protocols. Future research should include larger sample sizes, longer follow-up periods, and examine the synergistic effects of exercise and other lifestyle modifications. Integrating physical exercise into comprehensive IBS management plans can enhance symptom control and improve patients' quality of life.
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Affiliation(s)
- Chunpeng Li
- Russian Sports University, Moscow 105122, Russia;
| | - Jianmin Li
- School of Tai Chi Culture Handan University, Handan 056005, China;
| | - Qiaorui Zhou
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (Q.Z.); (C.W.)
| | - Can Wang
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing 100083, China; (Q.Z.); (C.W.)
| | - Jiahui Hu
- Moscow State Normal University, Moscow 127051, Russia
| | - Chang Liu
- School of Sport Science, Beijing Sport University, Beijing 100084, China
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12
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Kamp K, Gohres K, Tormey LK, Bardach SH, Szkodny LE, Salwen-Deremer JK. Barriers to Engagement with Gastrointestinal Health Management. Dig Dis Sci 2024:10.1007/s10620-024-08585-5. [PMID: 39126453 DOI: 10.1007/s10620-024-08585-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Although behavioral interventions have been effective in gastrointestinal (GI) conditions, barriers exist in implementing these interventions into clinical practice. The majority of previously published studies have focused on workforce limitations and have not considered individual and social determinants of health (SDoH) factors that can impact engagement in GI behavioral healthcare. AIMS To characterize barriers to engagement in appointment attendance and health management, explore individual and SDoH factors impacting GI behavioral healthcare engagement, and identify barriers that occur more often for patients with SDoH-related vulnerability (low health literacy and/or financial insecurity). METHODS A survey was distributed to adult patients who had been seen in Gastroenterology at the Dartmouth-Hitchcock Medical Center from June 2022 to December 2022. RESULTS One hundred participants [mean age = 58 years, 57.1% women] completed the survey. SDoH vulnerability was present in 32.3% of the population. For the entire sample, 73% reported at least one barrier to accessing care and 75% reported at least one factor which impacted health management. Those with SDoH vulnerability reported significantly more barriers to attending appointments and to managing health. In addition, they were significantly more likely to endorse physical health problems, difficulty affording medical bills, pain, mobility issues, trauma experiences, significant stress, and difficulty with concentration. CONCLUSIONS Patients in a GI clinic reported multiple barriers to accessing care and participating in health management. Innovative, multi-level strategies are needed to address barriers to ensure that all patients are able to obtain quality GI behavioral health services.
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Affiliation(s)
- Kendra Kamp
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, 98195, USA
| | - Katherine Gohres
- Geisel School of Medicine at Dartmouth College, Hanover, NH, 03755, USA
| | - Lauren K Tormey
- Center for Digestive Health, Dartmouth-Hitchcock Medical Center, Medical Center Drive, Lebanon, NH, 03756, USA
| | - Shoshana H Bardach
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, 03756, USA
| | - Lauren E Szkodny
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - Jessica K Salwen-Deremer
- Center for Digestive Health, Dartmouth-Hitchcock Medical Center, Medical Center Drive, Lebanon, NH, 03756, USA.
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA.
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13
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Sendzischew Shane MA, Ruddy J, Cline M, Rosenbaum DP, Edelstein S, Moshiree B. Review of the Patient Burden and Therapeutic Landscape of Irritable Bowel Syndrome with Constipation in the United States. Clin Exp Gastroenterol 2024; 17:227-253. [PMID: 39114809 PMCID: PMC11303673 DOI: 10.2147/ceg.s464375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 06/25/2024] [Indexed: 08/10/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a common disorder of the gut-brain axis. IBS with constipation (IBS-C) accounts for approximately one-third of IBS cases and is associated with substantial burden of illness and decreased quality of life. This narrative review provides an overview of the current and upcoming treatment options and disease management for IBS-C from a US perspective and discusses the importance of the relationship between patient and health care provider in diagnosis and treatment. A positive diagnostic strategy for IBS-C is recommended, based on clinical history, physical examination, and minimal laboratory tests. An effective communication strategy between patients and health care professionals is essential to ensure early diagnosis and reduce both health care costs and overall disease burden. Treatment typically begins with lifestyle interventions and nonpharmacologic options, such as dietary interventions, fiber supplements, and osmotic laxatives. In patients with inadequate response to these therapies, 4 currently available therapies (lubiprostone, linaclotide, plecanatide, and tenapanor) approved by the US Food and Drug Administration may relieve IBS-C symptoms. These agents are generally well tolerated and efficacious in improving IBS-C symptoms, including constipation and abdominal pain. In patients with persistent abdominal pain and/or psychological symptoms, brain-gut behavioral therapy or neuromodulator therapy may be beneficial.
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Affiliation(s)
| | | | - Michael Cline
- Department of Gastroenterology, Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Baharak Moshiree
- Division of Gastroenterology, Advocate Health Wake Forest Medical University, Charlotte, NC, USA
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14
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Valtierra Oba ER, Anguiano Morán AC, Calderón Cortes E, Valtierra Oba MI, Lemus Loeza BM, Rodríguez-Orozco AR. Irritable Bowel Syndrome in the Elderly Population: A Comprehensive Review. Cureus 2024; 16:e68156. [PMID: 39347183 PMCID: PMC11439088 DOI: 10.7759/cureus.68156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2024] [Indexed: 10/01/2024] Open
Abstract
Irritable bowel syndrome (IBS) is a fairly common functional digestive disorder; it occurs at any age but it is more common in adults and older adults. Patients experience a series of symptoms in which abdominal pain and changes in bowel movements stand out; some studies have revealed a possible association between IBS and psychological problems, such as anxiety and depression. Recent findings point to disorders of gut-brain interaction, disruption and alteration of gut microbiota and dysbiosis as key factors in the etiopathogenesis of IBS; aging is also one the factors involved. Most patients diagnosed with IBS required pharmacotherapy, greater caution needs to be considered when treating older patients because of the risk-benefit profile in the elderly. In this scenario, probiotics and non-pharmacological treatments appear as safe and accessible options. Clinicians must take into consideration the unique biopsychosocial factors in older adults when treating IBS. We aim to review critically recent literature on the topic of IBS as there is a need for consolidated guidelines.
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15
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Kulin D, Shah A, Fairlie T, Wong RK, Fang X, Ghoshal UC, Kashyap PC, Mulak A, Lee YY, Talley NJ, Koloski N, Jones MP, Holtmann GJ. The COVID-19 pandemic as a modifier of DGBI symptom severity: A systematic review and meta-analysis. Neurogastroenterol Motil 2024:e14878. [PMID: 39056447 DOI: 10.1111/nmo.14878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 06/24/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND This SRMA reviewed and assessed the changes in the severity of disorders of gut-brain interaction (DGBI) symptoms during the COVID-19 pandemic, and evaluated factors associated with symptom severity changes. METHODS Electronic databases were searched until February 2024, for articles reporting on changes in symptom severity in DGBI patients during the COVID-19 pandemic. The proportion of DGBI patients who reported a change in their symptom severity were pooled using a random-effects model, and subgroup analyses were conducted to assess the effect of socio-cultural modifiers on symptom severity in DGBI. KEY RESULTS Twelve studies including 3610 DGBI patients found that 31.4% (95% CI, 15.9-52.5) of DGBI patients experienced symptom deterioration, while 24.3% (95% CI, 10.2-47.5) experienced improvement. Countries with high gross domestic product (GDP) had a 43.5% (95% CI, 16.3-75.2) likelihood of symptom deterioration, compared to 9.2% (95% CI, 1.4-42.2) in lower GDP countries. Similarly, countries with low COVID fatality rates had a 60.1% (95% CI, 19.7-90.3) likelihood of symptom deterioration, compared to 18.3% (95% CI, 7.8-36.9) in higher fatality rate countries. Countries with lenient COVID policies had a 58.4% (95% CI, 14.1-92.3) likelihood of symptom deterioration, compared to 19% (95% CI, 8.2-38.1) in countries with stricter policies. Patients in high vaccine hesitancy countries had a 51.4% (95% CI, 19.5-82.2) likelihood of symptom deterioration, compared to 10.6% (95% CI, 2.7-33.4) in low vaccine hesitancy countries. CONCLUSIONS & INFERENCES This meta-analysis reveals that a significantly higher proportion of DGBI patients experienced deterioration of symptoms during the COVID-19 pandemic. Various sociocultural, economic and environmental factors potentially modify the effects of the COVID-19 pandemic on DGBI.
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Affiliation(s)
- Dmitrii Kulin
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ayesha Shah
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Thomas Fairlie
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Reuben K Wong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiucai Fang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Uday C Ghoshal
- Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, India
| | - Purna C Kashyap
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Agata Mulak
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wroclaw, Poland
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
- GI Function & Motility Unit, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nicholas J Talley
- School of Medicine and Public Health, and Hunter Medical Research Institute, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Natasha Koloski
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Michael P Jones
- Macquarie University, School of Psychological Sciences, Sydney, New South Wales, Australia
| | - Gerald J Holtmann
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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16
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Wang J, Mei L, Hao Y, Xu Y, Yang Q, Dai Z, Yang Y, Wu Z, Ji Y. Contemporary Perspectives on the Role of Vitamin D in Enhancing Gut Health and Its Implications for Preventing and Managing Intestinal Diseases. Nutrients 2024; 16:2352. [PMID: 39064795 PMCID: PMC11279818 DOI: 10.3390/nu16142352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/11/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Vitamin D, a crucial fat-soluble vitamin, is primarily synthesized in the skin upon exposure to ultraviolet radiation and is widely recognized as a bone-associated hormone. However, recent scientific advancements have unveiled its intricate association with gut health. The intestinal barrier serves as a vital component, safeguarding the intestinal milieu and maintaining overall homeostasis. Deficiencies in vitamin D have been implicated in altering the gut microbiome composition, compromising the integrity of the intestinal mucosal barrier, and predisposing individuals to various intestinal pathologies. Vitamin D exerts its regulatory function by binding to vitamin D receptors (VDR) present in immune cells, thereby modulating the production of pro-inflammatory cytokines and influencing the intestinal barrier function. Notably, numerous studies have reported lower serum vitamin D levels among patients suffering from intestinal diseases, including inflammatory bowel disease, irritable bowel syndrome, and celiac disease, highlighting the growing significance of vitamin D in gut health maintenance. This comprehensive review delves into the latest advancements in understanding the mechanistic role of vitamin D in modulating the gut microbiome and intestinal barrier function, emphasizing its pivotal role in immune regulation. Furthermore, we consolidate and present relevant findings pertaining to the therapeutic potential of vitamin D in the management of intestinal diseases.
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Affiliation(s)
- Jiaxin Wang
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Lihua Mei
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Yanling Hao
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing 100193, China;
| | - Yajun Xu
- Department of Nutrition and Food Hygiene, Peking University, Beijing 100083, China;
| | - Qing Yang
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Zhaolai Dai
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Ying Yang
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
| | - Zhenlong Wu
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing 100193, China;
| | - Yun Ji
- State Key Laboratory of Animal Nutrition and Feeding, China Agricultural University, Beijing 100193, China; (J.W.); (L.M.); (Q.Y.); (Z.D.); (Y.Y.); (Z.W.)
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17
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Hong H, Mocci E, Kamp K, Zhu S, Cain KC, Burr RL, Perry JA, Heitkemper MM, Weaver-Toedtman KR, Dorsey SG. Genetic Variations in TrkB.T1 Isoform and Their Association With Somatic and Psychological Symptoms in Individuals With IBS. THE JOURNAL OF PAIN 2024:104634. [PMID: 39004388 DOI: 10.1016/j.jpain.2024.104634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/13/2024] [Accepted: 06/19/2024] [Indexed: 07/16/2024]
Abstract
Irritable bowel syndrome (IBS), a disorder of gut-brain interaction, is often comorbid with somatic pain and psychological disorders. Dysregulated signaling of brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), has been implicated in somatic-psychological symptoms in individuals with IBS. We investigated the association of 10 single-nucleotide polymorphisms (SNPs) in the regulatory 3' untranslated region of neurotrophic receptor tyrosine kinase-2 (NTRK2) kinase domain-deficient truncated isoform (TrkB.T1) and BDNF Val66Met SNP with somatic and psychological symptoms and quality-of-life (QoL) in a cohort from the United States (IBS, n = 464; healthy controls, n = 156). We found that the homozygous recessive genotype (G/G) of rs2013566 in individuals with IBS is associated with worsened somatic symptoms, including headache, back pain, joint pain, muscle pain, and somatization as well as diminished sleep quality, energy level, and overall QoL. Validation using United Kingdom BioBank data confirmed the association of rs2013566 with an increased likelihood of headache. Several SNPs (rs1627784, rs1624327, and rs1147198) showed significant associations with muscle pain in our U.S. cohort. These 4 SNPs are predominantly located in H3K4Me1-enriched regions, suggesting their enhancer and/or transcription regulation potential. Our findings suggest that genetic variation within the 3' untranslated region region of the TrkB.T1 isoform may contribute to comorbid conditions in individuals with IBS, resulting in a spectrum of somatic and psychological symptoms impacting their QoL. These findings advance our understanding of the genetic interaction between BDNF/TrkB pathways and somatic-psychological symptoms in IBS, highlighting the importance of further exploring this interaction for potential clinical applications. PERSPECTIVE: This study aims to understand the genetic effects on IBS-related symptoms across somatic, psychological, and quality-of-life (QoL) domains, validated by United Kingdom BioBank data. The rs2013566 homozygous recessive genotype correlates with worsened somatic symptoms and reduced QoL, emphasizing its clinical significance.
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Affiliation(s)
- Hyejeong Hong
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Evelina Mocci
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD
| | - Kendra Kamp
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA
| | - Shijun Zhu
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD
| | - Kevin C Cain
- Department of Biostatistics, University of Washington School of Nursing, Seattle, WA
| | - Robert L Burr
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA
| | - James A Perry
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Margaret M Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA
| | - Kristen R Weaver-Toedtman
- Department of Biobehavioral Health and Nursing Science, University of South Carolina College of Nursing, Columbia, SC
| | - Susan G Dorsey
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD.
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18
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Bergman D, Roelstraete B, Sun J, Ebrahimi F, Butwicka A, Pardi DS, Ludvigsson JF. Psychiatric Disorders Among 5,800 Patients With Microscopic Colitis: A Nationwide Population-Based Matched Cohort Study. Am J Gastroenterol 2024:00000434-990000000-01248. [PMID: 38994845 DOI: 10.14309/ajg.0000000000002955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 06/17/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Microscopic colitis (MC) is an inflammatory condition of the large intestine. Primarily diagnosed in middle-aged and older adults, the incidence of the disease has increased markedly during the past few decades. While MC is associated with a reduced quality of life, large-scale studies on the association with future psychiatric disorders are lacking. METHODS We conducted a nationwide matched cohort study in Sweden from 2006 to 2021. Through a nationwide histopathology database (the Epidemiology Strengthened by histoPathology Reports in Sweden study), we identified 5,816 patients with a colorectal biopsy consistent with MC. These patients were matched with 21,509 reference individuals from the general population all of whom with no previous record of psychiatric disorders. RESULTS From 2006 to 2021, 519 patients with MC (median age 64.4 years [interquartile range = 49.5-73.3]) and 1,313 reference individuals were diagnosed with psychiatric disorders (9.9 vs 6.5 events per 1,000 person-years), corresponding to 1 extra case of psychiatric disorder in 29 patients with MC over 10 years. After adjustments, the hazard ratio for psychiatric disorders was 1.57 (95% confidence interval = 1.42-1.74). We found significantly elevated estimates up to 10 years after MC diagnosis and a trend toward higher risk with increasing age. Specifically, we observed increased risks for unipolar depression, anxiety disorders, stress-related disorders, substance abuse, and suicide attempts. In sibling-controlled analysis, the adjusted hazard ratio was 1.76 (95% confidence interval = 1.44-2.15). DISCUSSION Patients with MC are at increased risk of incident psychiatric disorders compared with the general population.
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Affiliation(s)
- David Bergman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bjorn Roelstraete
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jiangwei Sun
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fahim Ebrahimi
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Gastroenterology and Hepatology, Clarunis University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland
| | - Agnieszka Butwicka
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Akershus University Hospital, Lørenskog, Division of Mental Health Services, R&D Department, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Darrell S Pardi
- Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatrics, Orebro University Hospital, Orebro, Sweden
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA
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19
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Strom NI, Verhulst B, Bacanu SA, Cheesman R, Purves KL, Gedik H, Mitchell BL, Kwong AS, Faucon AB, Singh K, Medland S, Colodro-Conde L, Krebs K, Hoffmann P, Herms S, Gehlen J, Ripke S, Awasthi S, Palviainen T, Tasanko EM, Peterson RE, Adkins DE, Shabalin AA, Adams MJ, Iveson MH, Campbell A, Thomas LF, Winsvold BS, Drange OK, Børte S, Ter Kuile AR, Nguyen TH, Meier SM, Corfield EC, Hannigan L, Levey DF, Czamara D, Weber H, Choi KW, Pistis G, Couvy-Duchesne B, Van der Auwera S, Teumer A, Karlsson R, Garcia-Argibay M, Lee D, Wang R, Bjerkeset O, Stordal E, Bäckmann J, Salum GA, Zai CC, Kennedy JL, Zai G, Tiwari AK, Heilmann-Heimbach S, Schmidt B, Kaprio J, Kennedy MM, Boden J, Havdahl A, Middeldorp CM, Lopes FL, Akula N, McMahon FJ, Binder EB, Fehm L, Ströhle A, Castelao E, Tiemeier H, Stein DJ, Whiteman D, Olsen C, Fuller Z, Wang X, Wray NR, Byrne EM, Lewis G, Timpson NJ, Davis LK, Hickie IB, Gillespie NA, Milani L, Schumacher J, Woldbye DP, Forstner AJ, Nöthen MM, Hovatta I, Horwood J, Copeland WE, Maes HH, McIntosh AM, Andreassen OA, Zwart JA, Mors O, Børglum AD, Mortensen PB, Ask H, Reichborn-Kjennerud T, Najman JM, Stein MB, Gelernter J, Milaneschi Y, Penninx BW, Boomsma DI, Maron E, Erhardt-Lehmann A, Rück C, Kircher TT, Melzig CA, Alpers GW, Arolt V, Domschke K, Smoller JW, Preisig M, Martin NG, Lupton MK, Luik AI, Reif A, Grabe HJ, Larsson H, Magnusson PK, Oldehinkel AJ, Hartman CA, Breen G, Docherty AR, Coon H, Conrad R, Lehto K, Deckert J, Eley TC, Mattheisen M, Hettema JM. Genome-wide association study of major anxiety disorders in 122,341 European-ancestry cases identifies 58 loci and highlights GABAergic signaling. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.03.24309466. [PMID: 39006447 PMCID: PMC11245051 DOI: 10.1101/2024.07.03.24309466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
The major anxiety disorders (ANX; including generalized anxiety disorder, panic disorder, and phobias) are highly prevalent, often onset early, persist throughout life, and cause substantial global disability. Although distinct in their clinical presentations, they likely represent differential expressions of a dysregulated threat-response system. Here we present a genome-wide association meta-analysis comprising 122,341 European ancestry ANX cases and 729,881 controls. We identified 58 independent genome-wide significant ANX risk variants and 66 genes with robust biological support. In an independent sample of 1,175,012 self-report ANX cases and 1,956,379 controls, 51 of the 58 associated variants were replicated. As predicted by twin studies, we found substantial genetic correlation between ANX and depression, neuroticism, and other internalizing phenotypes. Follow-up analyses demonstrated enrichment in all major brain regions and highlighted GABAergic signaling as one potential mechanism underlying ANX genetic risk. These results advance our understanding of the genetic architecture of ANX and prioritize genes for functional follow-up studies.
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Affiliation(s)
- Nora I Strom
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Brad Verhulst
- Psychiatry and Behavioral Sciences, Texas A&M University, College Station, Texas, USA
| | | | - Rosa Cheesman
- PROMENTA Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Kirstin L Purves
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hüseyin Gedik
- Institute for Genomics in Health, Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
- Life Sciences, Integrative Life Sciences Doctoral Program, Virginia Commonwealth University, Richmond, Virginia, USA
- Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Brittany L Mitchell
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, Queensland University , Brisbane, Queensland, Australia
| | - Alex S Kwong
- Bristol Medical School, Population Health Sciences, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Centre for Clinical Brain Sciences, Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Annika B Faucon
- Division of Medicine, Human Genetics, Vanderbilt University, Nashville, Tennessee, USA
| | - Kritika Singh
- Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sarah Medland
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Lucia Colodro-Conde
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Kristi Krebs
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Biomedicine, Human Genomics Research Group, University of Basel; University Hospital Basel, Basel, Switzerland
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, Medical Faculty, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, Human Genomics Research Group, University of Basel; University Hospital Basel, Basel, Switzerland
| | - Jan Gehlen
- Center for Human Genetics, University of Marburg, Marburg, Germany
| | - Stephan Ripke
- Dept. of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Swapnil Awasthi
- Dept. of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Teemu Palviainen
- Helsinki Institute of Life Science, Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Elisa M Tasanko
- Faculty of Medicine, Department of Psychology and Logopedics, SleepWell Research Program, University of Helsinki, Helsinki, Finland
| | - Roseann E Peterson
- Institute for Genomics in Health, Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
- Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Daniel E Adkins
- School of Medicine, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Andrey A Shabalin
- School of Medicine, Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Mark J Adams
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Matthew H Iveson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Archie Campbell
- College of Medicine and Veterinary Medicine, Institute of Genetics and Cancer; Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Laurent F Thomas
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- BioCore - Bioinformatics Core Facility, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bendik S Winsvold
- Division of Clinical Neuroscience, Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Ole Kristian Drange
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Mental Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- NORMENT Centre, University of Oslo, Oslo, Norway
- Centre of Precision Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- Department of Psychiatry, Sørlandet Hospital, Kristiansand, Norway
| | - Sigrid Børte
- Division of Clinical Neuroscience, Department of Research and Innovation; Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Abigail R Ter Kuile
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Tan-Hoang Nguyen
- Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sandra M Meier
- Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Elizabeth C Corfield
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute , Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Laurie Hannigan
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Daniel F Levey
- Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
- Psychiatry, Research, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Darina Czamara
- Department of Genes and Environment, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Karmel W Choi
- Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Giorgio Pistis
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Baptiste Couvy-Duchesne
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- ARAMIS laboratory, Paris Brain Institute, Paris, France
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Miguel Garcia-Argibay
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Donghyung Lee
- Department of Statistics, Miami University, Oxford, Ohio, USA
| | - Rujia Wang
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Science, Nord University, Levanger, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eystein Stordal
- Department of Psychiatry, Hospital Namsos, Nord-Trøndelag Health Trustt, Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Julia Bäckmann
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Giovanni A Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Child Psychiatry, National Institute of Developmental Psychiatry, São Paulo, Brazil
| | - Clement C Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - James L Kennedy
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Gwyneth Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Arun K Tiwari
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Sciences Department, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Division of Neurosciences and Clinical Translation, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Jaakko Kaprio
- Helsinki Institute of Life Science, Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Martin M Kennedy
- Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Joseph Boden
- Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Alexandra Havdahl
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- PROMENTA Centre, Department of Psychology, University of Oslo, Oslo, Norway
- Bristol Medical School, Population Health Sciences, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Christel M Middeldorp
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Fabiana L Lopes
- National Institute of Mental Health, Human Genetics Branch, National Institutes of Health, Bethesda, Maryland, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Nirmala Akula
- National Institute of Mental Health, Genetic Basis of Mood and Anxiety Disorders, National Institutes of Health, Bethesda, Maryland, USA
| | - Francis J McMahon
- National Institute of Mental Health, Genetic Basis of Mood and Anxiety Disorders, National Institutes of Health, Bethesda, Maryland, USA
- Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elisabeth B Binder
- Department of Genes and Environment, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Lydia Fehm
- Department of Psychology, Zentrum für Psychotherapie, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Enrique Castelao
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Henning Tiemeier
- Social and Behavioral Science, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - David Whiteman
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Catherine Olsen
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | | | - Naomi R Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Enda M Byrne
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Glyn Lewis
- UCL Division of Psychiatry, University College London, London, UK
| | - Nicholas J Timpson
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Lea K Davis
- Division of Genetic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - Lili Milani
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | | | - David P Woldbye
- Department of Neuroscience, Laboratory of Neural Plasticity, University of Copenhagen, Copenhagen, Denmark
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Center for Human Genetics, University of Marburg, Marburg, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Iiris Hovatta
- Faculty of Medicine, Department of Psychology and Logopedics and SleepWell Research Program, University of Helsinki, Helsinki, Finland
| | - John Horwood
- Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - William E Copeland
- UVM Medical Center, Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
| | - Hermine H Maes
- Human and Molecular Genetics, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
- Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Andrew M McIntosh
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Ole A Andreassen
- NORMENT Centre, University of Oslo, Oslo, Norway
- Centre of Precision Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- K. G. Jebsen Center for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Department of Research and Innovation; Musculoskeletal Health, Oslo University Hospital, Oslo, Norway
- Department of Public Health and Nursing, HUNT Center for Molecular and Clinical Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole Mors
- Department of Psychiatry, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
| | - Anders D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalised Medicine, Aarhus University, Aarhus, Denmark
| | - Preben B Mortensen
- The National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Helga Ask
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Centre, Department of Psychology, University of Oslo, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- PsychGen Centre for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- NORMENT Centre, University of Oslo, Oslo, Norway
| | - Jackob M Najman
- Faculty of Medicine, School of Public Health, University of Queensland, Herston, Queensland, Australia
| | - Murray B Stein
- Psychiatry, University of California San Diego, La Jolla, CA, USA
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Joel Gelernter
- Department of Psychiatry, Division of Human Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
- Psychiatry Research, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA
- Departments of Genetics and Neuroscience, Yale University of Medicine, New Haven, Connecticut, USA
| | - Yuri Milaneschi
- Amsterdam Neuroscience; Amsterdam Public Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Brenda W Penninx
- Amsterdam Neuroscience; Amsterdam Public Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Dorret I Boomsma
- Twin Register and Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Eduard Maron
- Psychiatry, University of Tartu, Tartu, Estonia
- Department of Medicine, Centre for Neuropsychopharmacology,, Division of Brain Sciences, Imperial College London, London, UK
| | - Angelika Erhardt-Lehmann
- Department of Genes and Environment, Max-Planck Institute of Psychiatry, Munich, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Tilo T Kircher
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Christiane A Melzig
- Psychology, Clinical Psychology, Experimental Psychopathology and Psychotherapy, University of Marburg, Marburg, Germany
- Psychology, Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Georg W Alpers
- School of Social Sciences, Department of Psychology, University of Mannheim, Mannheim, Germany
| | - Volker Arolt
- Department of Mental Health, Institute for Translational Psychiatry, University of Muenster, Muenster, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- German Center for Mental Health (DZPG), Partner Site Berlin, Berlin, Germany
| | - Jordan W Smoller
- Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Psychiatry, Center for Precision Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Nicholas G Martin
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Michelle K Lupton
- Brain and Mental Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Medicine, Queensland University , Brisbane, Queensland, Australia
- Faculty of Health, Queensland University of technology, Queensland, Australia
| | - Annemarie I Luik
- Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Henrik Larsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Albertine J Oldehinkel
- Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Catharina A Hartman
- Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anna R Docherty
- School of Medicine, Psychiatry, University of Utah, Salt Lake City, Utah, USA
- School of Medicine, Psychiatry; Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hilary Coon
- School of Medicine, Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Kelli Lehto
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Thalia C Eley
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Manuel Mattheisen
- Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - John M Hettema
- Psychiatry and Behavioral Sciences, Texas A&M University, Bryan, Texas, USA
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Almansour O. Prevalence of Irritable Bowel Syndrome (IBS) in the Arab World: A Systematic Review. Cureus 2024; 16:e65421. [PMID: 39184662 PMCID: PMC11344969 DOI: 10.7759/cureus.65421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/27/2024] Open
Abstract
Irritable Bowel Syndrome (IBS) is a common functional pathology of the gastrointestinal tract (GIT) across the globe. The prevalence rate of IBS varies across the regions. In the present systematic review, we aim to investigate the prevalence of IBS in Arab countries in recent years. To identify relevant studies, a comprehensive search was undertaken in various databases including CINAHL (Cumulated Index to Nursing and Allied Health Literature) Ultimate, Scopus, PubMed, and Web of Science. Furthermore, Google Scholar was also explored to identify relevant studies. The inclusion criteria included studies that assessed IBS in the Arab world and were published in the English language. Fifty-two cross-sectional studies from seven countries, encompassing 51,683 participants, were included. The majority of the included studies were conducted in Saudi Arabia (n=40), followed by Jordan (n=4) and Egypt (n=3). The highest prevalence rates were reported by studies from Saudi Arabia, Lebanon, and Jordan. Low prevalence rates (<20%) were noted in 19 studies included in this systematic review. Female predominance in IBS prevalence was observed in most studies, while only two studies indicated higher prevalence in males. Key risk factors included family history, anxiety, depression, gastroesophageal reflux disease, low income, diabetes, low water intake, workload, occupation, food allergy, smoking, age, chronic diseases, and stress. IBS prevalence in the Arab world varies significantly. Female predominance was seen in the present systematic review as well.
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Liu H, Chen J, Li X, Pang J, Gao Y, Gao J, Yuan Y, Yu X, Li Y, Zhang Y. Prevalence and Influencing Factors of Irritable Bowel Syndrome Among Nurses in China: A Cross-Sectional Study. Gastroenterol Nurs 2024; 47:250-259. [PMID: 39087990 DOI: 10.1097/sga.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/06/2023] [Indexed: 08/02/2024] Open
Abstract
The aims of this study were to investigate the prevalence and influencing factors of irritable bowel syndrome among nurses in order to update the epidemiological data. A questionnaire survey was administered to 1,325 clinical nurses. We used a questionnaire for demographic information, the IBS Severity Scoring System, the IBS Quality of Life questionnaire, the Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Maslach Burnout Inventory to conduct our survey. Univariate and multivariate analyses were performed to detect factors influencing irritable bowel syndrome among nurses. The prevalence of irritable bowel syndrome was 13.3%, and the severity of symptoms was mostly moderate. The IBS Quality of Life score was significantly reduced (p < .001). Various foods that caused abdominal pain (egg and dairy products [OR = 4.80], greasy food [OR = 5.80], spicy food [OR = 2.66], raw and cold food [OR = 2.43]), a family history of gastrointestinal diseases (OR = 1.64, 95% CI [1.038, 2.587]), drinking weak green tea (OR = 1.71, 95% CI [1.143, 2.552]), mild depression (OR = 1.78, 95% CI [1.005, 3.156]), and the personal accomplishment dimension of occupational burnout (OR = 2.52, 95% CI [1.039, 6.114]) had important effects on nurses suffering from irritable bowel syndrome. On the contrary, exercising 1-2 hours per week (OR = 0.53, 95% CI [0.327, 0.859]) had a protective effect. The prevalence of irritable bowel syndrome among nurses is relatively high and may be influenced by several factors including genetics, diet, exercise, psychology, and occupational burnout.
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Affiliation(s)
- Hongyuan Liu
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Jie Chen
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Xiangning Li
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Juan Pang
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yajun Gao
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Juan Gao
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yuan Yuan
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Xiaoping Yu
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yaoyao Li
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
| | - Yu Zhang
- Hongyuan Liu, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Jie Chen, PhD, is at Department of Gastroenterology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China
- Xiangning Li, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Pang, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Yajun Gao, MSN, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China
- Juan Gao, MSN, is at Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yuan Yuan, MSN, is at Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Xiaoping Yu, BS, is at People's Hospital of Yizheng, Yizheng, Yangzhou, Jiangsu Province, China
- Yaoyao Li, PhD, Department of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China
- Yu Zhang, PhD, is at School of Nursing, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, Jiangsu Province, China
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22
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Deng A, Espiridion ED. Multipronged Electronic Health Record Analysis of Antidepressant Effectiveness on Depression Remission in Patients With Concurrent Depression and Irritable Bowel Syndrome. Cureus 2024; 16:e64968. [PMID: 39161523 PMCID: PMC11331275 DOI: 10.7759/cureus.64968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2024] [Indexed: 08/21/2024] Open
Abstract
Background Patients with irritable bowel syndrome (IBS) often experience chronic abdominal pain and bowel habit changes, with a heightened risk of depression and anxiety compared to the general population. Methods Using TriNetX data from 61 U.S. healthcare organizations, we conducted a retrospective study of three electronic health record (EHR) analyses. We used International Classification of Diseases, Tenth Revision (ICD-10) and Anatomical Therapeutic Chemical Classification (ATC) codes to analyze depression remission among IBS patients, comparing those using antidepressants to those who were not and comparing outcomes among different types of medication. Statistical methods included risk difference, risk ratio, hazard ratio, Kaplan-Meier survival analysis, log-rank tests, and Cox hazard ratios Results Among 78,673 patients with both depression and IBS, those using antidepressants showed significantly higher rates of depressive remission compared to non-users: risk difference (RD), -0.056; risk ratio (RR), 0.380; and hazard ratio (HR), 0.413. Both atypical antidepressants bupropion and trazodone exhibited greater efficacy in achieving remission compared to selective serotonin reuptake inhibitors (SSRIs), sertraline and escitalopram. For SSRI vs bupropion, RD is -0.041, RR is 0.664, and HR is 0.655. For SSRIs vs trazodone, RD is -0.018 , RR is 0.822, and HR is 0.806. The comparative impact of bupropion versus trazodone on remission remains inconclusive. Conclusion Depression presents a significant comorbidity in IBS patients, with atypical antidepressants potentially offering superior efficacy in achieving remission compared to SSRIs. Further research should explore these medications' psychiatric outcomes in this population to better understand their therapeutic benefits beyond gastrointestinal (GI) symptoms.
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Affiliation(s)
- Ashley Deng
- Psychiatry, Drexel University College of Medicine, West Reading, USA
| | - Eduardo D Espiridion
- Psychiatry, Drexel University College of Medicine, West Reading, USA
- Psychiatry, Reading Hospital Tower Health, West Reading, USA
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23
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Ghoshal UC, Mustafa U, Pandey VK. Rome III and IV criteria are less discordant to diagnose irritable bowel syndrome in clinic patients than in community subjects. Indian J Gastroenterol 2024:10.1007/s12664-024-01611-4. [PMID: 38951366 DOI: 10.1007/s12664-024-01611-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/13/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Though Rome IV criteria for irritable bowel syndrome (IBS) are less sensitive; they select Rome III patients with greater severity and consultation behavior. Since severity of IBS may determine consultation behavior, we compared Rome III and IV criteria in clinic patients and compared with earlier published data from Indian community hypothesizing that the diagnostic discordance between these criteria would be less in clinic than in community. METHODS Tertiary clinic patients were screened for IBS using Hindi translated-validated Rome III and IV questionnaires; IBS symptom severity scores (IBS-SSS) was also assessed. Diagnostic discordance between Rome III and IV criteria for IBS was compared with earlier published Indian community data. RESULTS Of 110 clinic patients with functional gastrointestinal disorders, 72 met IBS criteria (47 [42.7%], 22 [20%] and three [2.7%] both Rome III and IV criteria, Rome III criteria only and Rome IV criteria only, respectively). In contrast, of 40 IBS subjects from Indian community published earlier, nine (22.5%), 28 (70%) and three (7.5%) fulfilled both Rome III and IV, Rome III only, Rome IV only criteria, respectively. Clinic patients with IBS fulfilling both Rome III and IV criteria or Rome IV criteria had higher IBS-SSS than those fulfilling Rome III criteria only (295.3 ± 80.7 vs. 205.6 ± 65.7; p < 0.00001). This difference was primarily related to pain severity and number of days with pain. CONCLUSION Discordance between Rome IV and Rome III criteria in tertiary care clinic patients is less than in community subjects with IBS in India.
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Affiliation(s)
- Uday C Ghoshal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India.
- Gastroenterology and Chief, Luminal Gastroenterology and GI Motility, Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, 700 054, India.
| | - Uzma Mustafa
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
| | - Vipin Kumar Pandey
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, 226 014, India
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24
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Gawey BJ, Mars RA, Kashyap PC. The role of the gut microbiome in disorders of gut-brain interaction. FEBS J 2024. [PMID: 38922780 DOI: 10.1111/febs.17200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/03/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
Disorders of Gut-Brain Interaction (DGBI) are widely prevalent and commonly encountered in gastroenterology practice. While several peripheral and central mechanisms have been implicated in the pathogenesis of DGBI, a recent body of work suggests an important role for the gut microbiome. In this review, we highlight how gut microbiota and their metabolites affect physiologic changes underlying symptoms in DGBI, with a particular focus on their mechanistic influence on GI transit, visceral sensitivity, intestinal barrier function and secretion, and CNS processing. This review emphasizes the complexity of local and distant effects of microbial metabolites on physiological function, influenced by factors such as metabolite concentration, duration of metabolite exposure, receptor location, host genetics, and underlying disease state. Large-scale in vitro work has elucidated interactions between host receptors and the microbial metabolome but there is a need for future research to integrate such preclinical findings with clinical studies. The development of novel, targeted therapeutic strategies for DGBI hinges on a deeper understanding of these metabolite-host interactions, offering exciting possibilities for the future of treatment of DGBI.
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Affiliation(s)
- Brent J Gawey
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ruben A Mars
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Purna C Kashyap
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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25
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Khosravi M, Alzahrani AA, Muhammed TM, Hjazi A, Abbas HH, AbdRabou MA, Mohmmed KH, Ghildiyal P, Yumashev A, Elawady A, Sarabandi S. Management of Refractory Functional Gastrointestinal Disorders: What Role Should Psychiatrists Have? PHARMACOPSYCHIATRY 2024. [PMID: 38897220 DOI: 10.1055/a-2331-7684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Currently, it has been stated that psychiatric and psychological problems are equally paramount aspects of the clinical modulation and manifestation of both the central nervous and digestive systems, which could be used to restore balance. The present narrative review aims to provide an elaborate description of the bio-psycho-social facets of refractory functional gastrointestinal disorders, psychiatrists' role, specific psychiatric approach, and the latest psychiatric and psychological perspectives on practical therapeutic management. In this respect, "psyche," "psychiatry," "psychology," "psychiatrist," "psychotropic," and "refractory functional gastrointestinal disorders" (as the keywords) were searched in relevant English publications from January 1, 1950, to March 1, 2024, in the PubMed, Web of Science, Scopus, EMBASE, Cochrane Library, and Google Scholar databases. Eventually, the narrative technique was adopted to reach a compelling story with a high level of cohesion through material synthesis. The current literature recognizes the brain-gut axis modulation as a therapeutic target for refractory functional gastrointestinal disorders and the bio-psycho-social model as an integrated framework to explain disease pathogenesis. The results also reveal some evidence to affirm the benefits of psychotropic medications and psychological therapies in refractory functional gastrointestinal disorders, even when psychiatric symptoms were absent. It seems that psychiatrists are required to pay higher levels of attention to both the assessment and treatment of patients with refractory functional gastrointestinal disorders, accompanied by educating and training practitioners who take care of these patients.
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Affiliation(s)
- Mohsen Khosravi
- Department of Psychiatry, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Thikra M Muhammed
- Department of Biotechnology, College of Applied Sciences, University of Fallujah, Al-anbar, Iraq
| | - Ahmed Hjazi
- Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Huda H Abbas
- National University of Science and Technology, Dhi Qar, Iraq
| | - Mervat A AbdRabou
- Department of Biology, College of Science, Jouf University, Sakaka, Saudi Arabia
| | | | - Pallavi Ghildiyal
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India
| | - Alexey Yumashev
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ahmed Elawady
- College of technical engineering, the Islamic University, Najaf, Iraq
- College of technical engineering, the Islamic University of Al Diwaniyah, Al Diwaniyah, Iraq
- College of technical engineering, the Islamic University of Babylon, Babylon, Iraq
| | - Sahel Sarabandi
- Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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26
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Li Z, Ma Q, Deng Y, Rolls ET, Shen C, Li Y, Zhang W, Xiang S, Langley C, Sahakian BJ, Robbins TW, Yu JT, Feng J, Cheng W. Irritable Bowel Syndrome Is Associated With Brain Health by Neuroimaging, Behavioral, Biochemical, and Genetic Analyses. Biol Psychiatry 2024; 95:1122-1132. [PMID: 38199582 DOI: 10.1016/j.biopsych.2023.12.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/14/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Irritable bowel syndrome (IBS) interacts with psychopathology in a complex way; however, little is known about the underlying brain, biochemical, and genetic mechanisms. METHODS To clarify the phenotypic and genetic associations between IBS and brain health, we performed a comprehensive retrospective cohort study on a large population. Our study included 171,104 participants from the UK Biobank who underwent a thorough assessment of IBS, with the majority also providing neuroimaging, behavioral, biochemical, and genetic information. Multistage linked analyses were conducted, including phenome-wide association analysis, polygenic risk score calculation, and 2-sample Mendelian randomization analysis. RESULTS The phenome-wide association analysis showed that IBS was linked to brain health problems, including anxiety and depression, and poor cognitive performance. Significantly lower brain volumes associated with more severe IBS were found in key areas related to emotional regulation and higher-order cognition, including the medial orbitofrontal cortex/ventromedial prefrontal cortex, anterior insula, anterior and mid-cingulate cortices, dorsolateral prefrontal cortex, and hippocampus. Higher triglycerides, lower high-intensity lipoprotein, and lower platelets were also related (p < 1 × 10-10) to more severe IBS. Finally, Mendelian randomization analyses demonstrated potential causal relationships between IBS and brain health and indicated possible mediating effects of dyslipidemia and inflammation. CONCLUSIONS For the first time, this study provides a comprehensive understanding of the relationship between IBS and brain health phenotypes, integrating perspectives from neuroimaging, behavioral performance, biochemical factors, and genetics, which is of great significance for clinical applications to potentially address brain health impairments in patients with IBS.
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Affiliation(s)
- Zeyu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Qing Ma
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yueting Deng
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Edmund T Rolls
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Department of Computer Science, University of Warwick, Coventry, United Kingdom; Oxford Centre for Computational Neuroscience, Oxford, United Kingdom.
| | - Chun Shen
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yuzhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Christelle Langley
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Barbara J Sahakian
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W Robbins
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Jin-Tai Yu
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Department of Computer Science, University of Warwick, Coventry, United Kingdom; Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, China.
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Department of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, China.
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Lee AH, Mahurkar-Joshi S, Naliboff B, Gupta A, Labus J, Tillisch K, Mayer E, Chang L. Role of Sex, Anxiety, and Resilience in the Association between Adverse Childhood Experiences and Irritable Bowel Syndrome. Clin Gastroenterol Hepatol 2024:S1542-3565(24)00517-2. [PMID: 38878847 DOI: 10.1016/j.cgh.2024.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/14/2024] [Accepted: 05/28/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND & AIMS Adverse childhood experiences (ACE) are associated with increased risk of irritable bowel syndrome (IBS), a female-predominant chronic abdominal disorder. Factors contributing to this association have not been well-studied. We compared sex differences in ACE for adults with and without IBS and evaluated the impact of anxiety and resilience on the relationship between ACE and IBS. METHODS Sex and disease differences in total score and ACE subtypes from the ACE Questionnaire in subjects with IBS and control subjects were assessed. Cross-sectional mediation analysis determined if anxiety (Hospital Anxiety and Depression Scale) and resilience (Connor-Davidson Resilience Scale or Brief Resilience Scale) mediated the relationship between ACE and IBS. RESULTS Of 798 participants studied, 368 met IBS diagnostic criteria (265 women, 103 men) and 430 were healthy control subjects (277 women, 153 men). Prevalence and number of ACE were higher in IBS versus control subjects (P < .001) but similar between IBS women and men. Household mental illness increased odds of having IBS in women (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.35-2.85; false discovery rate [FDR], 0.002) and men (OR, 2.32; 95% CI, 1.26-4.33; FDR, 0.014). Emotional abuse increased odds of having IBS in women (OR, 1.94; 95% CI, 1.23-3.09; FDR, 0.019) and sexual abuse increased odds of IBS in men (OR, 3.54; 95% CI, 1.35-10.38; FDR, 0.027). Anxiety mediated 54% (P < .001) of ACE's effect on IBS risk and resilience mediated 12%-14% (Connor-Davidson Resilience Scale, P = .008; Brief Resilience Scale, P = .018). CONCLUSIONS Both men and women with a history of ACE are twice as likely to have IBS than those without an ACE. Anxiety mediated the relationship between ACE and IBS in men and women and resilience mediated this relationship only in women.
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Affiliation(s)
- Anna H Lee
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Swapna Mahurkar-Joshi
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Bruce Naliboff
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Jennifer Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Kirsten Tillisch
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Emeran Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California
| | - Lin Chang
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche & Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California.
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28
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Black CJ, Houghton LA, West RM, Bangdiwala SI, Palsson OS, Sperber AD, Ford AC. Novel Irritable Bowel Syndrome Subgroups are Reproducible in the Global Adult Population. Clin Gastroenterol Hepatol 2024:S1542-3565(24)00518-4. [PMID: 38876193 DOI: 10.1016/j.cgh.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/14/2024] [Accepted: 05/28/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND & AIMS Current classification systems for irritable bowel syndrome (IBS) based on bowel habit do not consider psychological impact. We validated a classification model in a UK population with confirmed IBS, using latent class analysis, incorporating psychological factors. We applied this model in the Rome Foundation Global Epidemiological Survey (RFGES), assessing impact of IBS on the individual and the health care system, and examining reproducibility. METHODS We applied our model to 2195 individuals in the RFGES with Rome IV-defined IBS. As described previously, we identified 7 clusters, based on gastrointestinal symptom severity and psychological burden. We assessed demographics, health care-seeking, symptom severity, and quality of life in each. We also used the RFGES to derive a new model, examining whether the broader concepts of our original model were replicated, in terms of breakdown and characteristics of identified clusters. RESULTS All 7 clusters were identified. Those in clusters with highest psychological burden, and particularly cluster 6 with high overall gastrointestinal symptom severity, were more often female, exhibited higher levels of health care-seeking, were more likely to have undergone previous abdominal surgeries, and had higher symptom severity and lower quality of life (P < .001 for trend for all). When deriving a new model, the best solution consisted of 10 clusters, although at least 2 seemed to be duplicates, and almost all mapped on to the previous clusters. CONCLUSIONS Even in the community, our original clusters derived from patients with physician-confirmed IBS identified groups of individuals with significantly higher rates of health care-seeking and abdominal surgery, more severe symptoms, and impairments in quality of life.
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Affiliation(s)
- Christopher J Black
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom
| | - Lesley A Houghton
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom
| | - Robert M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Olafur S Palsson
- Center for Functional GI & Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina
| | - Ami D Sperber
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom.
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29
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Dickstein DR, Edwards CR, Rowan CR, Avanessian B, Chubak BM, Wheldon CW, Simoes PK, Buckstein MH, Keefer LA, Safer JD, Sigel K, Goodman KA, Rosser BRS, Goldstone SE, Wong SY, Marshall DC. Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus. Nat Rev Gastroenterol Hepatol 2024; 21:377-405. [PMID: 38763974 DOI: 10.1038/s41575-024-00932-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/21/2024]
Abstract
The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
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Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Collin R Edwards
- Department of Radiology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Catherine R Rowan
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Bella Avanessian
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health at Temple University, Philadelphia, PA, USA
| | - Priya K Simoes
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael H Buckstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie A Keefer
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua D Safer
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Keith Sigel
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health at University of Minnesota, Minneapolis, MN, USA
| | - Stephen E Goldstone
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Serre-Yu Wong
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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30
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Grassi G, Pampaloni I. Gut Microbiota and Gastrointestinal Symptoms in the Global Assessment of Obsessive-Compulsive Disorder: A Narrative Review of Current Evidence and Practical Implications. Brain Sci 2024; 14:539. [PMID: 38928539 PMCID: PMC11201482 DOI: 10.3390/brainsci14060539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/19/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
A growing body of literature suggests a link between bowel syndromes (e.g., irritable bowel syndrome and inflammatory bowel disease), gut microbiome alterations, and psychiatric disorders. This narrative review aims to explore the potential role of the gut microbiome in the pathogenesis and clinical presentation of obsessive-compulsive disorder (OCD) and to explore whether there is sufficient evidence to warrant considering gastrointestinal symptoms and their implication for the gut microbiome during the assessment and treatment of OCD. For this purpose, a PubMed search of studies focusing on OCD, gut microbiota, irritable bowel syndrome, and inflammatory bowel disease was conducted by two independent reviewers. While the current literature on gut microbiome and gastrointestinal issues in OCD remains limited, emerging evidence suggests gut microbiome alterations and high rates of bowel syndromes in this population. These findings emphasize the importance of incorporating comprehensive gastrointestinal assessments into the "global assessment of OCD". Such assessment should encompass various factors, including gastrointestinal physical comorbidities and symptoms, nutritional habits, bowel habits, fluid intake, exercise patterns, and potential microbiome dysfunctions and inflammation. Considering the treatment implications, interventions targeting gut health, such as probiotics and dietary modifications, may hold promise in improving symptoms in OCD patients with comorbid gastrointestinal problems. Further research in this area is warranted to better understand the interplay between gut health and OCD and to explore the effectiveness of targeted interventions in improving clinical outcomes.
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Affiliation(s)
| | - Ilenia Pampaloni
- National OCD and BDD Unit, South West London and St Georges NHS Trust, London SW17 7DJ, UK;
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31
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Bai C, Wang J, Wang Y, Liu H, Li J, Wang S, Bai Z, Guo R. Exploration of the mechanism of Traditional Chinese Medicine for anxiety and depression in patients with diarrheal irritable bowel syndrome based on network pharmacology and meta-analysis. Front Pharmacol 2024; 15:1404738. [PMID: 38835657 PMCID: PMC11148253 DOI: 10.3389/fphar.2024.1404738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/26/2024] [Indexed: 06/06/2024] Open
Abstract
Background The efficacy of Chinese herbal medicine (CHM) in managing irritable bowel syndrome with diarrhea (IBS-D) accompanied by anxiety and depression remains uncertain. Thus, a systematic review was carried out employing meta-analysis and network pharmacology to ascertain the efficacy and underlying mechanisms of CHM therapy. Methods By conducting a systematic review, including literature search, screening, and data extraction, we identified 25 randomized controlled trials to assess CHM's effectiveness in treating irritable bowel syndrome alongside anxiety and depression. Network pharmacology was utilized to scrutinize the metabolite utility of CHM in addressing this condition. Potential primary mechanisms were synthesized using information sourced from the PubMed database. Results Twenty-five studies, including 2055 patients, were analyzed, revealing significant treatment efficacy for IBS-D in the trial group compared to controls [OR = 4.01, 95% CI (2.99, 5.36), I2 = 0%] Additionally, treatment for depression [SMD = -1.08, 95% CI (-1.30, -0.86), p < 0.00001, I2 = 68%; SDS: SMD = -1.69, 95% CI (-2.48, -0.90), p < 0.0001, I2 = 96%] and anxiety [HAMA: SMD = -1.29, 95% CI (-1.68, -0.91), p < 0.00001, I2 = 89%; SAS: SMD = -1.75, 95% CI (-2.55, -0.95), p < 0.00001, I2 = 96%] significantly improved in the trial group. Furthermore, the trial group exhibited a significantly lower disease relapse rate [OR = 0.30, 95% CI (0.20, 0.44), p < 0.00001, I2 = 0%]. CHM treatment consistently improved IBS severity (IBS-SSS) and symptom scores. Network pharmacology analysis identified key chemical metabolites in traditional Chinese medicine formulations, including Beta-sitosterol, Stigmasterol, Quercetin, Naringenin, Luteolin, Kaempferol, Nobiletin, Wogonin, Formononetin, and Isorhamnetin. Utilizing the STRING database and Cytoscape v3.9.0 software, a protein-protein interaction (PPI) network revealed the top eight key targets: IL-6, TNF, PPARG, PTGS2, ESR1, NOS3, MAPK8, and AKT1, implicated in anti-inflammatory responses, antioxidant stress modulation, and neurotransmitter homeostasis maintenance. Conclusion Chinese Herbal Medicine (CHM) offers a promising and safe treatment approach for patients dealing with Diarrheal Irritable Bowel Syndrome (IBS-D) accompanied by anxiety and depression; thus, indicating its potential for practical implementation. The most active metabolites of CHM could simultaneously act on the pathological targets of IBS-D, anxiety, and depression.The diverse scope of CHM's therapeutic role includes various aspects and objectives, underscoring its potential for broad utilization.
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Affiliation(s)
- Chen Bai
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Junyi Wang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yifan Wang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Haoqi Liu
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiaxiu Li
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Siyi Wang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhen Bai
- Department of Medical Equipment, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rongjuan Guo
- Psychosomatic Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
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32
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Tunnell NC, Corner SE, Roque AD, Kroll JL, Ritz T, Meuret AE. Biobehavioral approach to distinguishing panic symptoms from medical illness. Front Psychiatry 2024; 15:1296569. [PMID: 38779550 PMCID: PMC11109415 DOI: 10.3389/fpsyt.2024.1296569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/19/2024] [Indexed: 05/25/2024] Open
Abstract
Panic disorder is a common psychiatric diagnosis characterized by acute, distressing somatic symptoms that mimic medically-relevant symptoms. As a result, individuals with panic disorder overutilize personal and healthcare resources in an attempt to diagnose and treat physical symptoms that are often medically benign. A biobehavioral perspective on these symptoms is needed that integrates psychological and medical knowledge to avoid costly treatments and prolonged suffering. This narrative review examines six common somatic symptoms of panic attacks (non-cardiac chest pain, palpitations, dyspnea, dizziness, abdominal distress, and paresthesia), identified in the literature as the most severe, prevalent, or critical for differential diagnosis in somatic illness, including long COVID. We review somatic illnesses that are commonly comorbid or produce panic-like symptoms, their relevant risk factors, characteristics that assist in distinguishing them from panic, and treatment approaches that are typical for these conditions. Additionally, this review discusses key factors, including cultural considerations, to assist healthcare professionals in differentiating benign from medically relevant symptoms in panic sufferers.
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Affiliation(s)
- Natalie C. Tunnell
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
- Department of Psychiatry & Behavioral Sciences, The University of Kansas Medical Center, Kansas City, KS, United States
| | - Sarah E. Corner
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Andres D. Roque
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
- Primary Care Department, Miami VA Healthcare System, Miami, FL, United States
| | - Juliet L. Kroll
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
- Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
| | - Alicia E. Meuret
- Department of Psychology, Southern Methodist University, Dallas, TX, United States
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Nakaya K, Nakaya N, Kogure M, Hatanaka R, Chiba I, Kanno I, Nagaie S, Nakamura T, Kanazawa M, Ogishima S, Fuse N, Fukudo S, Hozawa A. Factors Associated With the Prevalence of Irritable Bowel Syndrome: The Miyagi Part of the Tohoku Medical Megabank Project Community-based Cohort Study. J Neurogastroenterol Motil 2024; 30:208-219. [PMID: 38576370 PMCID: PMC10999836 DOI: 10.5056/jnm23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/28/2023] [Accepted: 10/16/2023] [Indexed: 04/06/2024] Open
Abstract
Background/Aims The objective of this research is to examine factors related to irritable bowel syndrome (IBS) prevalence in a large population-based study. Methods A cross-sectional study was conducted with participants in the Miyagi part of the Tohoku Medical Megabank Project Community-Based cohort study who completed the Rome II Modular Questionnaire. Multivariate odds ratios (ORs) for the presence of IBS and 95% confidence intervals (95% CIs) for the reference group were calculated for each factor. Additionally, a stratified analysis was performed by sex and age group (20-49 years, 50-64 years, and ≥ 65 years). Results Among 16 252 participants, 3025 (18.6%) had IBS, comprising 750 men (15.5%) and 2275 women (19.9%). Multivariate ORs for the presence of IBS decreased significantly with each year of age (OR, 0.98; 95% CI, 0.98-0.99). Moreover, compared with the reference group, ORs for the presence of IBS were significantly higher in individuals whose home was partially damaged by the Great East Japan Earthquake, those with < 16 years of education, those who spent less time walking, those with high perceived stress (1.77, 1.57-2.01), those with high psychological distress (1.58, 1.36-1.82), and those with high symptoms of depression (1.76, 1.60-1.94). In stratified analyses, a significant relationship was found between psychological factors and IBS prevalence in all sex and age groups. Conclusions This large cross-sectional population-based cohort study identified several factors associated with IBS prevalence. Psychological factors were significantly associated with IBS prevalence across all age groups and sexes.
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Affiliation(s)
- Kumi Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Ippei Chiba
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Ikumi Kanno
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Faculty of Data Science, Kyoto Women’s University, Kyoto, Japan
| | | | - Soichi Ogishima
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shin Fukudo
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Guo Y, Lu Q, Yang XJ, He Y, Wu Y, Qin B, Li T, Duan M, Liu N, Wu X, He Y. Efficacy of Shu-yi-ning-chang decoction on IBS-D: Modulating Nr4a3 pathway to reduce visceral hypersensitivity. PLoS One 2024; 19:e0299376. [PMID: 38630738 PMCID: PMC11023393 DOI: 10.1371/journal.pone.0299376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/06/2024] [Indexed: 04/19/2024] Open
Abstract
AIM OF THE STUDY To evaluate the therapeutic effect of SYNC in diarrhea irritable bowel syndrome (IBS-D) and explore its underlying mechanism through transcriptomic sequencing (RNA-Seq). MATERIALS AND METHODS A rat model of IBS-D was constructed to elucidate the effects of SYNC. Abdominal withdrawal reflex (AWR), fecal water content (FWC), and recording body weight were calculated to assess visceral sensitivity in rats. Histopathological changes in the colon and alterations in mast cell (MC) count were determined. Immunohistochemistry was employed to assess mast cell tryptase (MCT) expression in rat colons. Serum levels of corticotropin-releasing Hormone (CRH), interleukin-6 (IL-6), calcitonin gene-related peptide (CGRP), and 5-hydroxytryptamine (5-HT) were quantified using ELISA. RNA-Seq of colon tissue was performed, followed by Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Western blot analysis was conducted to quantify the expression levels of key proteins in the Nr4a3 pathway in the colon and hypothalamus tissues of rats. RESULTS SYNC alleviated visceral hypersensitivity and mood disorders in rats with IBS-D. Moreover, it was positively correlated with its dosage and the observed effects, such as the enhancement of the colon's mucosal lining condition and reduction in the number and activation of MCs within the model group. SYNC reduced the expression levels of factors related to the brain-gut axis and inflammatory markers in the bloodstream. RNA-Seq analysis indicated that SYNC down-regulated the expression of Nr4a3 and PI3K. These SYNC-targeted genes primarily played roles in immune regulation and inflammatory responses, correlating with the modulation of Nr4a3 and the PI3K/AKT pathway. Western blot analysis further confirmed SYNC's influence on inflammation-related MC activation by downregulating key proteins in the Nr4a3/PI3K pathway. CONCLUSIONS SYNC inhibited mast cell activation and attenuated visceral hypersensitivity in the colon tissues of IBS-D rats. These effects were mediated by the Nr4a3/PI3K signaling pathway.
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Affiliation(s)
- Yajing Guo
- Department of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qiongqiong Lu
- Department of Gastroenterology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Xiao-Jun Yang
- Department of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Department of Gastroenterology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Yuxi He
- Department of Gastroenterology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Yue Wu
- Department of Gastroenterology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Baijun Qin
- Department of Gastroenterology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Ting Li
- Department of Pharmaceutical, Chongqing Medical University, Chongqing, China
| | - Min Duan
- Department of Clinical medicine, Changsha Hospital of Traditional Chinese Medicine Affiliated to Hunan University of Traditional Chinese Medicine, Changsha, Hunan, China
| | - Nvping Liu
- Department of Clinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Xin Wu
- Department of Clinical medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Yuanjun He
- Department of Gastroenterology, Chongqing City Hospital of Traditional Chinese Medicine, Chongqing, China
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Gaus OV, Livzan MA, Gavrilenko DA. Risk factors for irritable bowel syndrome: A review. TERAPEVT ARKH 2024; 96:159-167. [DOI: 10.26442/00403660.2024.02.202597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
Irritable bowel syndrome (IBS) is one of the most common diseases of the digestive tract from the group of disorders of interaction in the gut-brain axis. IBS has a negative impact of on patients' quality of life and the significant social and economic burden of the disease due to the low effectiveness of available treatment strategies, which are only symptomatic, without impacting factors and mechanisms of intestinal dysfunction. From this perspective, it is critical to study the factors contributing to the onset and persistence of IBS symptoms to improve the early diagnosis of the disease and implement targeted prevention technology in at-risk groups. The objective of this paper is to systematize data on the main risk factors for IBS, including hereditary predisposition, stress and psycho-emotional state, diet and eating habits, and acute intestinal infections.
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Ming X, Gao S, Sun J, Zhang N, Guo R, Feng X, Luan X, Xing H, Jiao Y, Guo F. Regulation of the MCHergic Neural Circuit to Dorsal Raphe Nucleus on Emotion-Related Behaviors and Intestinal Dysfunction in Mice Model of Irritable Bowel Syndrome with Diarrhea. Neuroendocrinology 2024; 114:605-622. [PMID: 38547853 DOI: 10.1159/000538582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 03/25/2024] [Indexed: 07/10/2024]
Abstract
INTRODUCTION Irritable bowel syndrome with diarrhea (IBS-D) is frequently accompanied by depression and anxiety, resulting in a reduced quality of life and increased medical expenditures. Although psychological factors are known to play an important role in the genesis and development of IBS-D, an understanding of the central neural control of intestinal dysfunction remains elusive. Melanin-concentrating hormone (MCH) is a gut-brain peptide involved in regulating feeding, sleep-wake rhythms, and emotional states. METHODS This study investigated the regulation of the MCHergic neural circuit from the lateral hypothalamic area (LHA) to the dorsal raphe nucleus (DRN) on anxiety- and depression-like behaviors, intestinal motility, and visceral hypersensitivity in a mice model of IBS-D. The models of IBS-D were prepared by inducing chronic unpredictable mild stress. RESULTS Chemogenetic activation of the MCH neurons in the LHA could excite serotonin (5-HT) neurons in the DRN and induce anxiety- and depression-like behaviors and IBS-D-like symptoms, which could be recovered by microinjection of the MCH receptor antagonist SNAP94847 into the DRN. The mice model of IBS-D showed a reduction of 5-HT and brain-derived neurotrophic factor (BDNF) expression in the DRN, while an elevation of 5-HT and BDNF was observed in the colon through immunofluorescent staining, ELISA, and Western blot analysis. SNAP94847 treatment in the DRN alleviated anxiety- and depression-like behaviors, improved intestinal motility, and alleviated visceral hypersensitivity responses by normalizing the 5-HT and BDNF expression in the DRN and colon. CONCLUSION This study suggests that the activation of MCH neurons in the LHA may induce IBS-D symptoms via the DRN and that the MCH receptor antagonist could potentially have therapeutic effects.
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Affiliation(s)
- Xing Ming
- Department of Physiology and Pathophysiology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Shengli Gao
- Biomedical Center, Qingdao Medical College, Qingdao University, Qingdao, China
| | - Jinqiu Sun
- Department of Physiology and Pathophysiology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Nana Zhang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ruixiao Guo
- Department of Physiology and Pathophysiology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Xufei Feng
- Department of Physiology and Pathophysiology, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Xinchi Luan
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Han Xing
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Yang Jiao
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Feifei Guo
- Department of Physiology and Pathophysiology, School of Basic Medicine, Qingdao University, Qingdao, China
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Ross SM. Irritable Bowel Syndrome: Effects of a Probiotic Combination in Reducing Stress Response and Symptoms Associated With Irritable Bowel Syndrome. Holist Nurs Pract 2024; 38:120-122. [PMID: 38363971 DOI: 10.1097/hnp.0000000000000639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Affiliation(s)
- Stephanie Maxine Ross
- Integrative Health Practitioner; served as the founding Director of Dept. of Complementary and Integrative Health, Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania
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Acciarino A, Diwakarla S, Handreck J, Bergola C, Sahakian L, McQuade RM. The role of the gastrointestinal barrier in obesity-associated systemic inflammation. Obes Rev 2024; 25:e13673. [PMID: 38111141 DOI: 10.1111/obr.13673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 12/20/2023]
Abstract
Systemic inflammation is a key contributor to the onset and progression of several obesity-associated diseases and is thought to predominantly arise from the hyperplasia and hypertrophy of white adipose tissue. However, a growing body of works suggests that early changes in the gastrointestinal (GI) barrier may contribute to both local, within the GI lining, and systemic inflammation in obesity. Intestinal barrier dysfunction is well-characterized in inflammatory GI disorders such as inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) and is known to contribute to systemic inflammation. Thus, drawing parallels between GI disorders, where intestinal permeability and systemic inflammation are prominent features, and obesity-induced GI manifestations may provide insights into the potential role of the intestinal barrier in systemic inflammation in obesity. This review summarizes the current literature surrounding intestinal barrier dysfunction in obesity and explores the potential role of intestinal hyperpermeability and intestinal barrier dysfunction in the development of systemic inflammation and GI dysfunction in obesity.
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Affiliation(s)
- Adriana Acciarino
- Gut Barrier and Disease Laboratory, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shanti Diwakarla
- Gut Barrier and Disease Laboratory, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jessica Handreck
- Gut Barrier and Disease Laboratory, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Cedrick Bergola
- Gut Barrier and Disease Laboratory, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lauren Sahakian
- Gut Barrier and Disease Laboratory, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rachel M McQuade
- Gut Barrier and Disease Laboratory, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Medicine, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Melbourne University, Melbourne, Victoria, Australia
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Zhu R, Zhang N, Zhu H, Li F, Xu H. Major depressive disorder and the risk of irritable bowel syndrome: A Mendelian randomization study. Mol Genet Genomic Med 2024; 12:e2413. [PMID: 38439604 PMCID: PMC10912794 DOI: 10.1002/mgg3.2413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/08/2023] [Accepted: 02/14/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The association between major depressive disorder (MDD) and irritable bowel syndrome (IBS) has been found in observational research; however, the causative relationship between MDD and IBS remains uncertain. Using the two-sample Mendelian randomization (MR) approach, we attempted to examine the causal effect of MDD on IBS. METHODS Independent genetic variants for MDD identified by Howard et al. based on a genome-wide meta-analysis were selected for this study. Gene-Outcome associations for IBS were gathered from UK Biobank and FinnGen databases. The MR analysis included inverse variance weighted (IVW), MR-Egger regression, weighted median, weighted mode, and MR-PRESSO sensitivity analyses. RESULTS FinnGen database subjected to inverse variance weighted (IVW) analysis revealed that MDD may be a risk factor for the development of IBS (OR = 1.356, 95% CI: 1.125-1.632, p = 0.0013). The same finding was reached in UK Biobank for IVW (OR = 1.011, 95% CI: 1.006-1.015, p = 3.18 × 10-7 ), MR-Egger progression (OR = 1.030, 95% CI: 1.008-1.051, p = 0.007), and weighted median (OR = 1.011, 95% CI: 1.005-1.016, p = 0.0001). CONCLUSION Our findings supported a causal relationship between MDD and IBS, which may have implications for the clinical management of IBS in individuals with MDD.
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Affiliation(s)
- Ruiming Zhu
- Department of EndoscopyThe First Hospital of Jilin UniversityChangchunJilinChina
| | - Nan Zhang
- Department of EndoscopyThe First Hospital of Jilin UniversityChangchunJilinChina
| | - He Zhu
- Department of EndoscopyThe First Hospital of Jilin UniversityChangchunJilinChina
| | - Fudong Li
- Department of EndoscopyThe First Hospital of Jilin UniversityChangchunJilinChina
| | - Hong Xu
- Department of EndoscopyThe First Hospital of Jilin UniversityChangchunJilinChina
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Shahkaram H, Yaztappeh JS, Sadeghi A, Kianimoghadam AS, Soltanabadi S, Bakhtiari M, Arani AM. Comparing the effectiveness of transdiagnostic treatment with acceptance and commitment therapy on emotional disorders, rumination, and life satisfaction in patients with irritable bowel syndrome: a randomized clinical trial. BMC Gastroenterol 2024; 24:66. [PMID: 38321387 PMCID: PMC10845775 DOI: 10.1186/s12876-024-03142-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/20/2024] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE The present study was conducted to compare the effectiveness of transdiagnostic treatment (UP) with the acceptance and commitment therapy (ACT) on the emotional disorders, rumination, and life satisfaction in the patients with irritable bowel syndrome (IBS). METHOD The present study was a randomized clinical trial with a pre-test and post-test design. Between the winter of 2021 and the end of spring 2022, Taleghani Hospital in Tehran received referrals from the statistical population of IBS patients. Of them, 30 individuals (15 in each group) were chosen by convenience sampling and then randomly allocated to groups. UP (It is emotion-based and intervenes in comorbid symptoms), and ACT treatments were provided to the participants online. The participants in the UP and ACT groups received the desired treatments in eight weekly sessions of 45-60 min. RESULTS There was no significant difference between UP pre-test and ACT regarding depression, anxiety, rumination, and life satisfaction (P > 0.05). There was no significant difference between UP and ACT post-test in terms of depression, rumination, and life satisfaction (P > 0.05), but due to anxiety, their difference was significant (P < 0.05). Besides, there was a significant difference between pre-test and post-test phases of UP and ACT regarding depression, anxiety, and rumination (P < 0.05). Still, they had no significant difference regarding life satisfaction (P > 0.05). CONCLUSION Therefore, it is suggested that specialists use UP and ACT as effective psychological treatments for the emotional symptoms of IBS patients to improve psychological symptoms.
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Affiliation(s)
- Homa Shahkaram
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jafar Sarani Yaztappeh
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Sadeghi
- Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Sam Kianimoghadam
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Samaneh Soltanabadi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Bakhtiari
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Masjedi Arani
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Loomba R, Zamani M. Reply. Clin Gastroenterol Hepatol 2024:S1542-3565(24)00101-0. [PMID: 38311149 DOI: 10.1016/j.cgh.2023.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 02/10/2024]
Affiliation(s)
- Rohit Loomba
- MASLD Research Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, California; Division of Gastroenterology and Hepatology, University of California San Diego, La Jolla, California
| | - Mohammad Zamani
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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de Graaf MCG, Lawton CL, Croden F, Smolinska A, Winkens B, Hesselink MAM, van Rooy G, Weegels PL, Shewry PR, Houghton LA, Witteman BJM, Keszthelyi D, Brouns FJPH, Dye L, Jonkers DMAE. The effect of expectancy versus actual gluten intake on gastrointestinal and extra-intestinal symptoms in non-coeliac gluten sensitivity: a randomised, double-blind, placebo-controlled, international, multicentre study. Lancet Gastroenterol Hepatol 2024; 9:110-123. [PMID: 38040019 DOI: 10.1016/s2468-1253(23)00317-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Many individuals without coeliac disease or wheat allergy reduce their gluten intake because they believe that gluten causes their gastrointestinal symptoms. Symptoms could be affected by negative expectancy. Therefore, we aimed to investigate the effects of expectancy versus actual gluten intake on symptoms in people with non-coeliac gluten sensitivity (NCGS). METHODS This randomised, double-blind, placebo-controlled, international, multicentre study was done at the University of Leeds (Leeds, UK), Maastricht University (Maastricht, the Netherlands), and Wageningen University and Research (Wageningen, the Netherlands). People aged 18-70 years with self-reported NCGS (ie, gastrointestinal symptoms within 8 h of gluten consumption) without coeliac disease and wheat allergy were recruited. Participants had to follow a gluten-free or gluten-restricted diet for at least 1 week before (and throughout) study participation and had to be asymptomatic or mildly symptomatic (overall gastrointestinal symptom score ≤30 mm on the Visual Analogue Scale [VAS]) while on the diet. Participants were randomly assigned (1:1:1:1; blocks of eight; stratified by site and gender) to one of four groups based on the expectation to consume gluten-containing (E+) or gluten-free (E-) oat bread for breakfast and lunch (two slices each) and actual intake of gluten-containing (G+) or gluten-free (G-) oat bread. Participants, investigators, and those assessing outcomes were masked to the actual gluten assignment, and participants were also masked to the expectancy part of the study. The primary outcome was overall gastrointestinal symptom score on the VAS, which was measured at and corrected for baseline (before breakfast) and hourly for 8 h, with lunch served after 4 h, and analysed per-protocol. Safety analysis included all participants incorporated in the per-protocol analysis. The study is registered at ClinicalTrials.gov, NCT05779358, and has ended. FINDINGS Between Oct 19, 2018, and Feb 14, 2022, 165 people were screened and 84 were randomly assigned to E+G+ (n=21), E+G- (n=21), E-G+ (n=20), or E-G- (n=22). One person in the E+G+ group was excluded due to not following test day instructions, leaving 83 participants in the per-protocol analysis. Median age was 27·0 years (IQR 21·0-45·0), 71 (86%) of 83 people were women, and 12 (14%) were men. Mean overall gastrointestinal symptom score was significantly higher for E+G+ (16·6 mm [95% CI 13·1 to 20·0]) than for E-G+ (6·9 mm [3·5 to 10·4]; difference 9·6 mm [95% CI 3·0 to 16·2], p=0·0010) and E-G- (7·4 mm [4·2 to 10·7]; difference 9·1 mm [2·7 to 15·6], p=0·0016), but not for E+G- (11·7 mm [8·3 to 15·1]; difference 4·9 mm [-1·7 to 11·5], p=0·28). There was no difference between E+G- and E-G+ (difference 4·7 mm [-1·8 to 11·3], p=0·33), E+G- and E-G- (difference 4·2 mm [-2·2 to 10·7], p=0·47), and E-G+ and E-G- (difference -0·5 mm [-7·0 to 5·9], p=1·0). Adverse events were reported by two participants in the E+G- group (itching jaw [n=1]; feeling lightheaded and stomach rumbling [n=1]) and one participant in the E-G+ group (vomiting). INTERPRETATION The combination of expectancy and actual gluten intake had the largest effect on gastrointestinal symptoms, reflecting a nocebo effect, although an additional effect of gluten cannot be ruled out. Our results necessitate further research into the possible involvement of the gut-brain interaction in NCGS. FUNDING Government of the Netherlands Topsector Agri & Food Top Consortium for Knowledge and Innovation, AB Mauri Global Bakery Ingredients, Baking Industry Research Trust, Borgesius-Albert Heijn, CSM Innovation Centre, the International Maize and Wheat Improvement Center (CIMMYT), DSM Food Specialties, Fazer, Healthgrain Forum, the International Association for Cereal Science and Technology, the International Wheat Gluten Association, Lantmännen, Mondelez International, Nederlands Bakkerij Centrum, Nutrition & Santé, Puratos, Rademaker, Sonneveld Group, and Zeelandia HJ Doeleman.
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Affiliation(s)
- Marlijne C G de Graaf
- Department of Gastroenterology-Hepatology, Maastricht University Medical Center+, Maastricht, Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | | | - Fiona Croden
- School of Psychology, University of Leeds, Leeds, UK
| | - Agnieszka Smolinska
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands; Department of Pharmacology and Toxicology, Maastricht University, Maastricht, Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Martine A M Hesselink
- Department of Gastroenterology-Hepatology, Maastricht University Medical Center+, Maastricht, Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Gonny van Rooy
- Department of Gastroenterology-Hepatology, Maastricht University Medical Center+, Maastricht, Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Peter L Weegels
- Laboratory of Food Chemistry, Wageningen University and Research, Wageningen, Netherlands; European Bakery Innovation Centre, Sonneveld Group, Papendrecht, Netherlands
| | | | - Lesley A Houghton
- Division of Gastroenterology and Surgical Sciences, Leeds Institute of Medical Research, University of Leeds, Leeds, UK; Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Ben J M Witteman
- Division of Human Nutrition, Wageningen University and Research, Wageningen, Netherlands; Division of Gastroenterology-Hepatology, Gelderse Vallei Hospital, Ede, Netherlands
| | - Daniel Keszthelyi
- Department of Gastroenterology-Hepatology, Maastricht University Medical Center+, Maastricht, Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Fred J P H Brouns
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands; Department of Human Biology, Maastricht University, Maastricht, Netherlands
| | - Louise Dye
- School of Psychology, University of Leeds, Leeds, UK; School of Food Science and Nutrition, University of Leeds, Leeds, UK
| | - Daisy M A E Jonkers
- Department of Gastroenterology-Hepatology, Maastricht University Medical Center+, Maastricht, Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands.
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Black CJ, Ng CE, Goodoory VC, Ford AC. Novel Symptom Subgroups in Individuals With Irritable Bowel Syndrome Predict Disease Impact and Burden. Clin Gastroenterol Hepatol 2024; 22:386-396.e10. [PMID: 36858142 DOI: 10.1016/j.cgh.2023.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND & AIMS Current classification systems based on bowel habit fail to capture the multidimensional nature of irritable bowel syndrome (IBS). We previously derived and validated a classification system, using latent class analysis, incorporating factors beyond bowel habit. We applied this in another cohort of people with IBS to assess its ability to capture the impact of IBS on the individual, the health care system, and society. METHODS We collected demographic, symptom, and psychological health data from adults in the community self-identifying as having IBS, and meeting Rome IV criteria. We applied our latent class analysis model to identify the 7 subgroups (clusters) described previously, based on overall gastrointestinal symptom severity and psychological burden. We assessed quality of life, health care costs (£1 = $1.20), employment status, annual income, work productivity, and ability to perform work duties in each cluster. RESULTS Of 1278 responders, 752 (58.8%) met Rome IV criteria. The 7-cluster model fit the data well. The patients in the 4 clusters with the highest psychological burden, and particularly those in cluster 6 with high overall gastrointestinal symptom severity and high psychological burden, showed lower educational levels, higher gastrointestinal symptom-specific anxiety, were more likely to have consulted a gastroenterologist, and used more drugs for IBS. IBS-related and generic quality of life were impaired significantly in these 4 clusters and significantly fewer individuals reported earning ≥£30,000 per year. Productivity and the ability to work, manage at home, engage in social and private leisure activities, and maintain close relationships all were impacted significantly, and IBS-related health care costs over the previous 12 months were highest in these 4 clusters. In those in cluster 6, costs were more than £1000 per person per year. CONCLUSIONS Our clusters identify groups of individuals with significant impairments in quality of life, earning potential, and ability to work and function socially, who are high utilizers of health care.
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Affiliation(s)
- Christopher J Black
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom
| | - Cho-Ee Ng
- Department of Gastroenterology, County Durham and Darlington National Health Service Foundation Trust, Durham, United Kingdom
| | - Vivek C Goodoory
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St. James's University Hospital, Leeds, United Kingdom; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, United Kingdom.
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Duan G, Wang J, Sun H, Dong Z, Zhang Y, Wang Z, Chen Y, Chen Y, Huang Y, Xu S. Overexpression of EphB2 in the basolateral amygdala is crucial for inducing visceral pain sensitization in rats subjected to water avoidance stress. CNS Neurosci Ther 2024; 30:e14611. [PMID: 38353051 PMCID: PMC10865153 DOI: 10.1111/cns.14611] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/13/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024] Open
Abstract
AIMS Basolateral amygdala (BLA), as a center for stress responses and emotional regulation, is involved in visceral hypersensitivity of irritable bowel syndrome (IBS) induced by stress. In the present study, we aimed to investigate the role of EphB2 receptor (EphB2) in BLA and explore the underlying mechanisms in this process. METHODS Visceral hypersensitivity was induced by water avoidance stress (WAS). Elevated plus maze test, forced swimming test, and sucrose preference test were applied to assess anxiety- and depression-like behaviors. Ibotenic acid or lentivirus was used to inactivate BLA in either the induction or maintenance stage of visceral hypersensitivity. The expression of protein was determined by quantitative PCR, immunofluorescence, and western blot. RESULTS EphB2 expression was increased in BLA in WAS rats. Inactivation of BLA or downregulation of EphB2 in BLA failed to induce visceral hypersensitivity as well as anxiety-like behaviors. However, during the maintenance stage of visceral pain, visceral hypersensitivity was only partially relieved but anxiety-like behaviors were abolished by inactivation of BLA or downregulation of EphB2 in BLA. Chronic WAS increased the expression of EphB2, N-methyl-D-aspartate receptors (NMDARs), and postsynaptic density protein (PSD95) in BLA. Downregulation of EphB2 in BLA reduced NMDARs and PSD95 expression in WAS rats. However, activation of NMDARs after the knockdown of EphB2 expression still triggered visceral hypersensitivity and anxiety-like behaviors. CONCLUSIONS Taken together, the results suggest that EphB2 in BLA plays an essential role in inducing visceral hypersensitivity. In the maintenance stage, the involvement of EphB2 is crucial but not sufficient. The increase in EphB2 induced by WAS may enhance synaptic plasticity in BLA through upregulating NMDARs, which results in IBS-like symptoms. These findings may give insight into the treatment of IBS and related psychological distress.
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Affiliation(s)
- Guang‐Bing Duan
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Jun‐Wen Wang
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Hui‐Hui Sun
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Zhi‐Yu Dong
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Yan Zhang
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Zhen‐Xiang Wang
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Ye Chen
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Ying Chen
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Ying Huang
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Ministry of Education), Department of Physiology and Pharmacology, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Shu‐Chang Xu
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
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Staudacher HM, Mahoney S, Canale K, Opie RS, Loughman A, So D, Beswick L, Hair C, Jacka FN. Clinical trial: A Mediterranean diet is feasible and improves gastrointestinal and psychological symptoms in irritable bowel syndrome. Aliment Pharmacol Ther 2024; 59:492-503. [PMID: 37969059 DOI: 10.1111/apt.17791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/17/2023] [Accepted: 10/20/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Diet is fundamental to the care of irritable bowel syndrome (IBS). However, some approaches are not appropriate for individuals experiencing psychological symptoms. AIMS To assess feasibility of a Mediterranean diet in IBS and its impact on gastrointestinal and psychological symptoms. METHODS We recruited adults with Rome IV IBS and mild or moderate anxiety and/or depressive symptoms to an unblinded 6-week randomised controlled trial. Patients were randomised to Mediterranean diet counselling or habitual diet. We collected gastrointestinal and psychological symptom data, dietary data and stool samples for metagenomic sequencing. RESULTS We randomised 59 individuals (29 Mediterranean diet, 30 control); 48 completed the study. The Mediterranean Diet Adherence Screener score was higher in the Mediterranean diet group than controls at week 6 (7.5 [95% CI: 6.9-8.0] vs. 5.7 [5.2-6.3], p < 0.001), and there was a greater score increase than controls (2.1 [95% CI: 1.3-2.9] vs. 0.5 [95% CI: 0.1-1.0], p = 0.004), demonstrating Mediterranean diet feasibility. There was a greater proportion of gastrointestinal symptom responders in the Mediterranean diet group than controls (24/29, 83% vs. 11/30, 37%, p < 0.001) and depression responders (15/29, 52% vs. 6/30 20%, p = 0.015). There was no difference in FODMAP intake at week 6 (p = 0.51). Gastrointestinal adverse events were similar (p = 0.588). There were no differences in change in microbiome parameters between groups. CONCLUSIONS A Mediterranean diet is feasible in IBS and leads to improvement in gastrointestinal and psychological symptoms. Although this study was unblinded, these findings together with the broader benefits of the Mediterranean diet, provide strong impetus for future research in IBS. Australia New Zealand Clinical Trials Registry: ACTRN12620001362987.
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Affiliation(s)
- Heidi M Staudacher
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Sophie Mahoney
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Kim Canale
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Rachelle S Opie
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Amy Loughman
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Daniel So
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- Department of Nutritional Sciences, King's College London, London, UK
| | - Lauren Beswick
- Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Chris Hair
- Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Felice N Jacka
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Zhang T, Chen Y, Li X, Zhang J, Duan L. Genetic associations and potential mediators between psychiatric disorders and irritable bowel syndrome: a Mendelian randomization study with mediation analysis. Front Psychiatry 2024; 15:1279266. [PMID: 38352653 PMCID: PMC10861787 DOI: 10.3389/fpsyt.2024.1279266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Objective Potential causal associations between psychiatric disorders and irritable bowel syndrome have been demonstrated in observational studies; however, these studies are susceptible to underlying confounding and reverse causation biases. We aimed to assess the causal effects of psychiatric disorders on irritable bowel syndrome (IBS) and the potential mediators from a genetic perspective by conducting a Mendelian randomization (MR) study with mediation analysis. Method Genetic instruments associated with psychiatric disorders, potential mediators, and IBS were obtained from large-scale genome-wide association studies (GWAS). Three MR methods - the inverse-variance weighted (IVW) method, MR-Egger method, and weighted median method, were used to investigate causal association estimates. Heterogeneity among different genetic instrumental variables (IVs) was assessed using Q tests. Additionally, the MR-PRESSO and MR-Pleiotropy methods were used to verify horizontal pleiotropy and detect outliers that might bias the results, which were removed from further analysis. Consequently, we used MR mediation analysis to investigate potential mediators in the causal associations between psychiatric disorders and IBS. Results MR provided evidence of the causal effects of genetically predicted broad depression, major depressive disorder (MDD), anxiety disorder, post-traumatic stress disorder (PTSD), and schizophrenia on IBS. The results of MR mediation analysis demonstrated that the reduction in acetate levels mediated 12.6% of the effects of broad depression on IBS; insomnia mediated 16.00%, 16.20%, and 27.14% of the effects of broad depression, MDD, and PTSD on IBS, respectively; and the increase in blood β-hydroxybutyrate levels mediated 50.76% of the effects of schizophrenia on IBS. Conclusion Our study confirmed the brain-gut axis involvement and potential modulators in the pathophysiology of psychiatric disorder-induced IBS from a genetic perspective, and suggests potential therapeutic targets for the disrupted brain-gut axis.
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Affiliation(s)
| | | | | | | | - Liping Duan
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
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Wang W, Wang M, Peng H, Huang J, Wu T. Association of major depressive disorder and increased risk of irritable bowel syndrome: A population-based cohort study and a two-sample Mendelian randomization study in the UK biobank. J Affect Disord 2024; 345:419-426. [PMID: 37852586 DOI: 10.1016/j.jad.2023.10.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/08/2023] [Accepted: 10/15/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To examine the association between depression and the risk of incident irritable bowel syndrome (IBS). METHODS We included 98,564 participants free of IBS in the UK biobank. Depression was defined by self-report and Hospital Episode Statistics. The main outcome was incident IBS. Cox proportional hazards regression models and two-sample mendelian randomization were performed to estimate the risk of incident IBS. RESULTS Among 98,564 participants, 8770 (8.9 %) participants had a depression diagnosis at baseline. During a median of 12.9-year follow-up, 224 cases of incident IBS were identified in patients with depression (2.0 per 1000 person-years), compared with 1625 cases in reference individuals (1.5 per 1000 person-years). After adjustment, the hazard ratio of incident IBS associated with depression was 1.26 (95 % CI: 1.01-1.41). Sensitivity analysis indicated similar results. The two-sample mendelian randomization based on the inverse variance weighted method provided evidence for the harmful role of depression in an increased risk of IBS with an OR of 1.57 (95 % CI: 1.24-1.99). LIMITATIONS Depression was mainly measured by self-report online CIDI-SF in the current study, rather than the gold diagnostic criteria including clinical structured interview, which might lead to potential measurement error. Lifestyle behaviors might change during the long-term follow-up, and time-varying covariates (i.e., smoking and alcohol status) may bias the estimate. CONCLUSIONS Depression is associated with an increased risk of incident IBS. Further studies are warranted to confirm the role of depression on incident IBS and elucidate the underlying mechanisms.
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Affiliation(s)
- Weiwei Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China; Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Lane, Xicheng District, Beijing 100088, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
| | - Hexiang Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China
| | - Jie Huang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China.
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, Beijing 100191, China.
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Halvorson CS, Sánchez-Lafuente CL, Johnston JN, Kalynchuk LE, Caruncho HJ. Molecular Mechanisms of Reelin in the Enteric Nervous System and the Microbiota-Gut-Brain Axis: Implications for Depression and Antidepressant Therapy. Int J Mol Sci 2024; 25:814. [PMID: 38255890 PMCID: PMC10815176 DOI: 10.3390/ijms25020814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/30/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
Current pharmacological treatments for depression fail to produce adequate remission in a significant proportion of patients. Increasingly, other systems, such as the microbiome-gut-brain axis, are being looked at as putative novel avenues for depression treatment. Dysbiosis and dysregulation along this axis are highly comorbid with the severity of depression symptoms. The endogenous extracellular matrix protein reelin is present in all intestinal layers as well as in myenteric and submucosal ganglia, and its receptors are also present in the gut. Reelin secretion from subepithelial myofibroblasts regulates cellular migration along the crypt-villus axis in the small intestine and colon. Reelin brain expression is downregulated in mood and psychotic disorders, and reelin injections have fast antidepressant-like effects in animal models of depression. This review seeks to discuss the roles of reelin in the gastrointestinal system and propose a putative role for reelin actions in the microbiota-gut-brain axis in the pathogenesis and treatment of depression, primarily reflecting on alterations in gut epithelial cell renewal and in the clustering of serotonin transporters.
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Affiliation(s)
- Ciara S. Halvorson
- Division of Medical Sciences, University of Victoria, 3800 Finnerty Rd., Victoria, BC V8P 5C2, Canada; (C.S.H.); (C.L.S.-L.); (L.E.K.)
| | - Carla Liria Sánchez-Lafuente
- Division of Medical Sciences, University of Victoria, 3800 Finnerty Rd., Victoria, BC V8P 5C2, Canada; (C.S.H.); (C.L.S.-L.); (L.E.K.)
| | - Jenessa N. Johnston
- Section on the Neurobiology and Treatment of Mood Disorders, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Lisa E. Kalynchuk
- Division of Medical Sciences, University of Victoria, 3800 Finnerty Rd., Victoria, BC V8P 5C2, Canada; (C.S.H.); (C.L.S.-L.); (L.E.K.)
| | - Hector J. Caruncho
- Division of Medical Sciences, University of Victoria, 3800 Finnerty Rd., Victoria, BC V8P 5C2, Canada; (C.S.H.); (C.L.S.-L.); (L.E.K.)
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Zeng Y, Liu H, Pei Z, Li R, Liu Z, Liao C. Evaluation of the causal effects of blood metabolites on irritable bowel syndrome: Mendelian randomization. BMC Gastroenterol 2024; 24:19. [PMID: 38182988 PMCID: PMC10768268 DOI: 10.1186/s12876-023-03111-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by abdominal pain, discomfort, and changes in bowel habits. The mechanism underlying IBS remains unclear, and little evidence exists for clarifying the causal relationship between blood metabolites and IBS. METHODS We conducted a Mendelian randomization (MR) study using two samples. Exposure data for 7824 Europeans were extracted from a genome-wide association study (GWAS) on metabolite levels. The IBS GWAS data from the GWAS database were used for the initial analysis. The primary analysis of causal relationships was conducted using inverse-variance weighting (IVW) with MR-Egger and weighted medians as supplementary analyses. Sensitivity analyses were performed using a combination of the Cochran's Q test, MR-Egger intercept test, Mendelian randomization pleiotropy residual sum and outlier, and leave-one-out analysis. For significant associations, replication and meta-analyses were performed using additional independent IBS case GWAS data released by the FinnGen Consortium R9. To identify the metabolites, score regression, confounding analysis, and reverse MR were performed to further assess the causal relationships between the metabolites. RESULTS After rigorous screening, we identified four known metabolites to be associated with IBS (stearate, odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.59-0.92; arginine, OR: 1.36, 95% CI: 1.07-1.74; 1-palmitoylglycerol, OR:1.49, 95% CI: 1.07-2.07; 1-palmitoylglycerophosphoinositol, OR: 0.84, 95% CI: 0.71-0.99). CONCLUSIONS MR analysis revealed a causal relationship between the four metabolites and IBS, providing preliminary evidence for the pathogenesis of IBS. Our results provide novel insights into the potential biomarkers of IBS.
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Affiliation(s)
- Yu Zeng
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Gastrointestinal Hernia Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Huabing Liu
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Gastrointestinal Hernia Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Zhihui Pei
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Gastrointestinal Hernia Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Rui Li
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Gastrointestinal Hernia Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Zuihui Liu
- Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Gastrointestinal Hernia Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China
| | - Chuanwen Liao
- Gastrointestinal Hernia Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, China.
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Kraimi N, Ross T, Pujo J, De Palma G. The gut microbiome in disorders of gut-brain interaction. Gut Microbes 2024; 16:2360233. [PMID: 38949979 PMCID: PMC11218806 DOI: 10.1080/19490976.2024.2360233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/21/2024] [Indexed: 07/03/2024] Open
Abstract
Functional gastrointestinal disorders (FGIDs), chronic disorders characterized by either abdominal pain, altered intestinal motility, or their combination, have a worldwide prevalence of more than 40% and impose a high socioeconomic burden with a significant decline in quality of life. Recently, FGIDs have been reclassified as disorders of gut-brain interaction (DGBI), reflecting the key role of the gut-brain bidirectional communication in these disorders and their impact on psychological comorbidities. Although, during the past decades, the field of DGBIs has advanced significantly, the molecular mechanisms underlying DGBIs pathogenesis and pathophysiology, and the role of the gut microbiome in these processes are not fully understood. This review aims to discuss the latest body of literature on the complex microbiota-gut-brain interactions and their implications in the pathogenesis of DGBIs. A better understanding of the existing communication pathways between the gut microbiome and the brain holds promise in developing effective therapeutic interventions for DGBIs.
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Affiliation(s)
- Narjis Kraimi
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Taylor Ross
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Julien Pujo
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Giada De Palma
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
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