Abstract
Irritable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits. Although generally considered a functional disorder, there is now substantial evidence that IBS is associated with a poor quality of life and significant negative impact on work and social domains. Neuroimaging studies documented changes in the prefrontal cortex, ventro-lateral and posterior parietal cortex and thalami, and implicate alteration of brain circuits involved in attention, emotion and pain modulation. Emerging data reveals the interaction between psychiatric disorders including generalized anxiety disorder, panic disorder, major depressive disorder, bipolar disorder, and schizophrenia and IBS, which suggests that this association should not be ignored when developing strategies for screening and treatment. Psychological, social and genetic factors appear to be important in the development of IBS symptomatology through several mechanisms: alteration of HPA axis modulation, enhanced perception of visceral stimuli or psychological vulnerability. Elucidating the molecular mechanisms of IBS with or without psychiatric comorbidities is crucial for elucidating the pathophysiology and for the identification of new therapeutical targets in IBS.
Highlights
Irritable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits [1,2]
The results demonstrated a higher prevalence of IBS symptoms in patients with depression compared with healthy subjects but patients with major depressive disorder (MDD) in remission did not differ from healthy controls in reporting gastrointestinal symptoms
A number of psychiatric comorbidities affect the patients with IBS
Summary
Irritable bowel syndrome (IBS) is a functional syndrome characterized by chronic abdominal pain accompanied by altered bowel habits [1,2]. Changes in the density of gray matter among regions involved in cognitive functions are observed in patients with IBS, albeit different levels of anxiety and depression can explain changes in other areas of the brain. The findings of another study on a sample of female IBS patients with moderate symptom severity suggest that morphometric alterations occur primarily in brain networks involved in attention and emotion modulation, as well as in pain modulatory networks, and in systems processing interoceptive information [22]. A cross-sectional study investigated the prevalence of IBS symptoms in patients diagnosed with major depressive disorder (MDD) [62]. Individuals with a diminished function of serotonin transporters are more sensitive to gut signals in emotionregulating brain regions [79,80]
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