By Cara Murez
health day reporter
WEDNESDAY, March 1, 2023 (HealthDay News) — When Dr. Yezaz Ghouri sees patients with cramps, abdominal pain, and diarrhea that are hallmark symptoms of irritable bowel syndrome (IBS), he usually asks how life is.
More often than not, his patients report experiencing stress in their lives.
Now, Ghouri’s team has linked IBS to anxiety, depression and suicidal ideation in patients who were admitted to hospital for their IBS. IBS is a chronic disorder of the gastrointestinal (GI) system that affects up to 15% of the population.
Ghouri, an assistant professor of clinical medicine and gastroenterology at the University of Missouri School of Medicine, thinks stress can express itself through both the mind and the body.
“I think it expresses itself in the form of mood disorders like depression, anxiety,” Ghouri said. “I think it expresses itself in a form of IBS, which is basically a manifestation of your autonomic nervous system [which controls involuntary actions like your heartbeat].”
The study used data from more than 1.2 million IBS patients at 4,000 US hospitals over three years.
More than 38% of these patients suffered from anxiety. More than 27% suffered from depression. These figures were twice the levels of anxiety and depression seen in patients who did not have IBS.
Lead researcher Dr. Zahid Ijaz Tarar, assistant professor of clinical medicine, pointed to something called the brain-gut axis. Tarar suggested in a university press release that IBS symptoms influence anxiety and depression, while these psychiatric issues can also cause IBS symptoms.
Ghouri said: “A lot of anxious people tend to have a higher heart rate. They may tend to be anxious. They tend to sweat a lot sometimes. These are all symptoms of the autonomic nervous system. And I believe IBS is also a manifestation of that autonomic nervous system through the gut-brain axis.”
Ghouri explained that patients with these symptoms may first need to learn to recognize their feelings of stress.
“That recognition is the most important part,” he said. “Number two, what are you going to do about it?”
Patients may need counseling, Ghouri noted.
Meditation, relaxation, healthy eating and good sleep are all factors that can contribute to a healthy life, he said.
In terms of improving gut health in particular, Ghouri suggests giving up or reducing processed or fatty foods, red meat, alcohol, and smoking, in favor of fruits, vegetables, and foods like yogurt. .
“I think it helps stabilize your gut microbiota, makes it a little healthier,” Ghouri said.
The team’s findings were recently published in the Irish Journal of Medical Sciences.
Dr. Brooks Cash, chief of the division of gastroenterology, hepatology and nutrition at the University of Texas Health Sciences Center at Houston, said the study reiterates some key information about IBS.
“I think it’s very important for us not to lose sight of the mental health component of gastrointestinal health. And I think this study helps highlight that,” said Cash, who was not involved in the study.
Cash’s view is that mental health issues can increase GI symptoms and GI symptoms can increase mental health issues, “but we don’t know if there is a true causal or causal relationship between the two”.
He noted what the study authors said about the importance of addressing physical and mental health symptoms in patients.
“It’s a very complementary and holistic approach that we have to take with these patients. We need to deal with the gastrointestinal symptoms as best we can, but we also need to be mindful of the mental health symptoms and deal with them,” Cash said.
Cash said the majority of people with IBS symptoms do not seek medical attention, but rather treat the symptoms themselves.
“There’s nothing wrong with doing that as long as they don’t ignore the alarm functions,” he said.
A variety of over-the-counter treatments can help, including laxatives and anti-diarrheal medications. There are also a handful of U.S. Food and Drug Administration-approved prescription medications for irritable bowel syndrome, Cash said. Dietary therapies can also make a difference.
Popular therapies include the low-FODMAP diet, which limits poorly digested carbohydrates, fiber, and complex sugars. This is used in patients with bloating and diarrhea. There is also growing evidence that prunes and kiwi may be effective for constipation.
“There are a number of different dietary and lifestyle modifications that patients can make, and every patient is different,” Cash said. “We need to take an individualized approach for each patient based on their symptoms.”
The US National Institute of Diabetes and Digestive and Kidney Diseases has more on irritable bowel syndrome.
SOURCES: Yezaz Ghouri, MD, assistant professor, clinical medicine and gastroenterology, University of Missouri School of Medicine, Columbia, Mo; Brooks Cash, MD, chief, division of gastroenterology, hepatology, and nutrition, University of Texas Health Science Center, Houston; Irish Journal of Medical SciencesJanuary 3, 2023