- A new meta-analysis suggests that mental health interventions may improve symptoms associated with inflammatory bowel disease (IBD).
- The researchers tracked biomarkers of IBD to reach their conclusions.
- Research results show that psychotherapy is very effective in reducing IBD symptoms.
A new meta-analysis (research study) from King’s College London strengthens existing knowledge of the brain-gut axis, which links mental health to the development and behavior of inflammatory bowel disease (IBD).
The findings suggest that improving symptoms of depression and anxiety in patients with inflammatory bowel disease can significantly reduce the severity of the condition.
In particular, mental health treatment interventions have been most successful in reducing inflammation associated with IBD.
Antidepressant medication and exercise also led to improvements, albeit to a smaller extent.
Rather than relying on self-reports of IBD symptoms, the researchers tracked levels of two biomarkers commonly associated with inflammation in IBD: calprotectin and C-reactive protein (CRP).
After searching five medical databases for relevant studies, the study’s authors analyzed data from 28 randomized controlled trials involving 1,789 participants. Biomarker data were included in the study analysis if they existed.
The study was published in
This new study builds on existing evidence and confirms the link between IBD and mental health.
The study’s first author, Natasha Seaton, a PhD student at King’s College, cited some of the
“Depression and anxiety are common in people with IBD. 25% of people with IBD have clinical depression and 32% have clinical anxiety. When the disease is active and inflammation levels are higher, these rates rise to 39% and 58%, respectively. .”
“If you take a snapshot of IBD patients over a certain time period, certain inflammatory markers appear to be associated with anxiety [or] Depression symptoms,” Seaton told Medical News Today.
Dr Tine Jess from the Center for Molecular Prediction of Inflammatory Bowel Disease told MNT: “There are multiple mechanistic links between mental health and intestinal inflammation, including
Dr. Rudolph Bedford, a gastroenterologist at St. John’s Physicians Partners in Santa Monica, Calif., who was not involved in the study, said a poor psychological state can increase pro-inflammatory responses.
“We also see this in gut dysbiosis, or bacterial overgrowth,” Dr. Bedford told us motor neurons.
“These things alter signaling in the brain and also alter signaling of underlying inflammatory cytokines. [With] Inflammatory bowel disease, and back and forth between the two,” he added.
Psychological intervention is superior to antidepressant medication in improving IBD symptoms.
“We know that the brain modulates some activity in the immune system and gut, so improved mood may be related to brain activity that reduces inflammation,” Seaton explains.
Better mental health is known to boost a person’s immune system, she said, noting that people with inflammatory bowel disease “are better able to manage their physical health, for example, more physical activity, better diet , improve sleep quality, [and they are] More likely to take prescription medications. “
“Psychotherapy can provide people with skills, such as CBT techniques, mindfulness exercises, and stress management strategies, which will enable them to better manage IBD and thereby improve physical health,” Seaton noted.
Researchers in this study tracked fecal calprotectin and CRP, two biomarkers of IBD, and drew their conclusions.
“Fecal calprotectin and CRP are used as measures of intestinal and systemic inflammation and therefore reflect disease activity in patients with IBD,” Dr. Jess explained.
Both biomarkers can help doctors objectively determine whether a patient with IBD is experiencing a flare-up or is currently in remission. Seaton said.
Bedford added that they are an important indicator of whether treatment is working in patients with IBD.
“If your calprotectin is normal, then you know there’s no inflammation in the colon, and the same goes for CRP — if it’s normal, then you know your treatment is working,” he said.
“This systematic review and meta-analysis shows that psychological interventions that address emotional outcomes have beneficial effects on both gut and systemic inflammation, which I think will still surprise a lot of people,” noted Dr. Jess.
Dr. Bedford points out, “Not everyone who has mood swings, depression, or anxiety will have inflammatory bowel disease. The reverse is also true—not everyone with inflammatory bowel disease will have depression or anxiety, “He said.
Dr. Bedford said that in his practice, they often refer patients with IBD for counseling.
“We found that when their anxiety and depression improved or were reduced in some way, their inflammatory bowel disease improved,” he said.
IBD is often confused with IBS (irritable bowel syndrome), but IBS does not involve inflammation.
“Inflammatory bowel disease is an inflammatory autoimmune disease in which debilitating symptoms—pain, fatigue, incontinence, diarrhea—are caused by inflammation of the gastrointestinal tract,” Seaton explains.
IBD is a collective term for three types of inflammatory bowel disease:
- Crohn’s disease affects any part of the gastrointestinal tract, from the mouth all the way to the anus.
- Ulcerative colitis, which affects any area of the large intestine.
- Indeterminate colitis Inflammatory bowel disease with features of Crohn’s disease and ulcerative colitis.
There are indications that Crohn’s disease is hereditary, as it tends to be suffered by multiple family members and disproportionately affects the Jewish population.