Correlation between diarrhea type irritable bowel syndrome overlapped with functional dyspepsia andpsychology and gastrointestinal hormones

Abstract

Objective To investigate the psychological status of diarrhea type irritable bowel syndrome （D-IBS） patients overlapped with functional dyspepsia （FD） and its relationship with the changes of brain-gut peptides and cytokines levels. Methods A total of 190 D-IBS-FD overlapped patients and 30 healthy controls were selected and all of them completed the questionnaire. The adult psychological testing system was applied for the Symptom Checklist （SCL-90） assessment. Plasma levels of 5-hydroxytryptamine （5-HT）, somatostatin （SS）, vasoactive intestinal peptide （VIP）, endothelin （ET）, interleukin （IL）-10 and IL-12 were measured in 59 randomly selected patients.Single factor analysis of variance and LSD test were performed for statistical analysis. Results In D- IBS-FD overlapped patients, the plasma 5-HT levels of the D-IBS patients and the FD patients were （1906.83±676. 88） μg/L and （1745. 53±653. 23） μg/L respectively, both of them were significant higher than those of control group [（1289.44±918.45） μg/L, LSD test, both P〈0. 051. However the levels of VIP and IL-10 were significant lower than those of control group （LSD test, both P〈0.01）. In D-IBS patients, the plasma level of SS was significantly lower than that of control group （LSD test, P=0. 025） ; the level of ET was significantly higher than that of control group and FD patients （LSD test, both P〈0. 05）. In D-IBS-FD overlapped patients, the scores of anxiety, depression and opponent were higher than those of control group （F=5. 114, 4. 555 and 10. 285, all P〈0.05）. The plasma VIP and SS levels of patients with anxiety or depression were lower than those of control group （LSD test, both P〈0.05）. The plasma VIP level was lower than that of patients without psychological disorders （LSD test, P=0. 005）. The plasma ET level of patients with disease course over five years was significantly higher than that of patients with disease course less than one year or between one and five years （LSD test, both P〈0.05）, and the IL-10 level was significantly lower than that of patients with disease course less than one year （LSD test, P=0. 004）. Conclusions There were sub-healthy psychology state in D-IBS-FD overlapped patients. The overlapping symptoms may be correlated with disease course, psychological disorder, the increased plasma 5-HT level and the decreased IL-10 level. There was close correlation between the lower gastrointestinal symptoms and the decreased levels of VIP, SS and the increased level of ET. Key words: Irritable bowel syndrome; Dyspepsia; Anxiety; Serotonin; InterIeukin 10; Vasoactive intestinal peptide; Somatostatin; Endotoxins