Irritable Bowel Syndrome Patients May Suffer Significantly Higher Rates of Anxiety, Depression and Suicidal Ideation

Summary: Study reveals a link between IBS and an increased risk of developing mental health disorders including anxiety, depression, and suicidal ideation. Researchers say identifying and treating mental health comorbidities in those with IBS improves the quality of life for sufferers.

Source: University of Missouri

New research from the University of Missouri School of Medicine has established a link between irritable bowel syndrome (IBS) and mental health challenges, such as anxiety, depression, and suicidal ideation.

The research highlights the need for health professionals to evaluate and treat associated psychiatric co-morbidities in IBS patients to improve their overall health and quality of life.

IBS is a chronic disorder of the stomach and intestines affecting up to 15 percent of the population. It causes cramping, abdominal pain, bloating, gas, and diarrhea. This study looked at more than 1.2 million IBS patient hospitalizations from 4,000 U.S. hospitals over a three-year period and found that more than 38-percent had anxiety, and more than 27-percent had depression.

Both figures were double the rate of anxiety and depression found in those without IBS. The prevalence of psychiatric problems including anxiety, depression, bipolar disorder, suicidal attempt/ideation, and eating disorders was significantly higher in the IBS patient population when compared to the general adult population.

This shows a man clutching his belly
IBS is a chronic disorder of the stomach and intestines affecting up to 15 percent of the population. Image is in the public domain

“One possible explanation is the so-called brain-gut axis,” said lead researcher Zahid Ijaz Tarar, MD, assistant professor of clinical medicine.

“We’ve long suspected that dysfunction of the brain-gut axis is bidirectional, such that IBS symptoms influence anxiety and depression, and on the other hand, psychiatric factors cause IBS symptoms. Medical professionals need to treat both ends of the axis.”

Untreated psychiatric disorders among IBS patients also puts additional strain on health care systems through increased frequency of hospital admissions and longer stays. Chronic diseases like IBS are also known to be associated with stress, work impairment, and associated economic burdens on patients and their families.

“I frequently tell my patients who have IBS, that if they have any type of psychologic stress, it will get expressed in some form or the other,” said senior author Yezaz Ghouri, MD, assistant professor of clinical medicine and gastroenterology.

“The mesentery membrane that holds the intestines together has one of the largest collections of nerve cells in the body. When those nerves start firing impulses, that can lead to the state of nervousness in and around the GI tract, resulting in IBS symptoms.

“The resulting decline in patient quality of life can lead to poor lifestyle choices, such as smoking. Early evaluation and treatment of both IBS and associated psychiatric conditions is essential.”

About this mental health and IBS research news

Author: Press Office
Source: University of Missouri
Contact: Press Office – University of Missouri
Image: The image is in the public domain

Original Research: Closed access.
Burden of anxiety and depression among hospitalized patients with irritable bowel syndrome: a nationwide analysis” by Zahid Ijaz Tarar et al. Irish Journal of Medical Science


Abstract

Burden of anxiety and depression among hospitalized patients with irritable bowel syndrome: a nationwide analysis

Background and aim

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder that affects patients both physically and mentally. Our study aimed to investigate the burden of psychiatric disorders in IBS patients.

Methods

We conducted a retrospective analysis of the National inpatient sample (NIS) from 2016 to 2019. We recruited patients admitted with a diagnosis of IBS and determined the prevalence of anxiety, depression, and suicide attempt/ideation.

Results

We found a total of 1,256,325 hospitalizations with a diagnosis of IBS. Among them, 478,515 (38.1%) had anxiety and 344,165 (27.4%) had depression. The prevalence of psychiatric disorders including anxiety (38.1% vs. 15.1%), depression (38.1% vs. 15.1%), bipolar disorder (5.22% vs. 2.38%), suicidal attempt/Ideation (3.22% vs. 2.38%), and eating disorder (0.32% vs. 0.08%) was significantly higher in IBS patient population when compared to general adult population (p < 0.001). Patients with IBS had greater odds of anxiety (AOR 2.88, 95% CI 2.85–2.91, P < 0.001), depression (AOR 2.16, 95% CI 2.14–2.19, P < 0.001) and suicidal attempt/ideation (AOR 1.94, 95% CI 1.88–2.00, P < 0.001) in comparison to general population. IBS subtypes including diarrhea-predominant, constipation-predominant and mixed type were independently associated with increased odds of anxiety, depression, and suicide attempt/ideation. Patients with IBS and a co-diagnosis of anxiety or depression had increased mean length of hospital stay by 0.48 (95% CI 0.43–0.52, P < 0.001) and 0.52 (95% CI 0.06–0.97, P < 0.03) days, respectively.

Conclusion

The presence of IBS is associated with an increased associated prevalence of psychiatric disorders such as anxiety, depression, and suicide attempt/ideation.

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