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Study on irritable bowel syndrome reveals gut-to-brain pathway

Australian researchers are learning more about how irritable bowel syndrome and anxiety are linked through specific gut-to-brain and brain-to-gut pathways, according to a study published in the July 22 issue of Alimentary Pharmacology and Therapeutics.

“We calculated in one-third of individuals a mood disorder precedes functional gastrointestinal disorder, but in two-thirds an FGID precedes the mood disorder,” researchers stated in the study. “This study provides strong direct evidence that the gut and brain interact bidirectionally in both IBS and functional dyspepsia.”

The study looked at a random sample of subjects from Newcastle, Australia in 2012 and followed up with them a year later. A total of 1900 surveys were completed at follow-up and analyzed by the researchers. They found that higher levels of anxiety and depression at baseline were significant predictors of developing IBS.

Among those who didn’t have elevated levels of anxiety at baseline but had IBS alone, there was a significant amount of anxiety reported at their one-year follow-up. In addition, 6.4% of respondents developed new onset IBS, 7.2% developed functional dyspepsia, and half who had IBS or FD at the beginning of the study reported that they no longer had symptoms.

IBS may first begin with gut symptoms such as diarrhea in people free of distress, “… and only later does new onset anxiety or depression develop, implicating gut disease as the primary driver of the entire symptom complex (a gut-to-brain disease),” Laureate Professor Nicholas J. Talley, one of the study’s researchers, said in a interview. “On the other hand, we speculated there is another quite different subgroup where disease begins with anxiety or depression and only later do new onset gut symptoms develop, and this is likely primarily a central nervous system cause (probably through the stress system), or a brain-to-gut disease.”

“Our novel observations may have profound treatment implications, because if anxiety begins first targeting this brain problem may provide the most benefit, but if gut symptoms begin first directing therapy to the gut may be the more effective approach, a hypothesis now worth testing in clinical trials,” Talley said in the interview.

According to the website, psychological factors are known to have a long-term effect on the physiological system. “Normal GI function is characterized by a high degree of coordination between the gut and brain,” the website stated. “However, in IBS patients, there is a disruption in this interaction of the brain-gut axis. This often results in abnormal gut motility and visceral hypersensitivity.”

Risk factors for developing psychological distress in IBS can include stress; comorbid psychiatric diagnoses such as anxiety and panic disorder; and emotion-focused rather than problem-focused coping, among others.

The Anxiety and Depression Association of America reports one in five adults have IBS. “The National Digestive Diseases Information Clearinghouse estimates that up to 70% of people with IBS are not receiving treatment,” the ADAA website stated. “Of those who do seek treatment, research has found that 50% to 90% have a psychiatric disorder such as an anxiety disorder or depression.”

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By | 2016-09-13T21:15:22-04:00 September 13th, 2016|Categories: Nursing News|Tags: |4 Comments

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Sallie Jimenez
Sallie Jimenez is content manager for healthcare for from Relias. She develops and edits content for the blog, which covers industry news and trends in the nursing profession and healthcare. She also develops content for the Digital Editions. She has more than 25 years of healthcare journalism, content marketing and editing experience.


  1. Avatar
    Kathy Lehrbaum September 16, 2016 at 2:23 am - Reply

    Fits me to a “T”

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    Daphne October 4, 2016 at 1:53 pm - Reply

    Supplements can help but understanding which elements of your diet cause your symptoms to be exaggerated is also important. If you suspect you have IBS there is a way through but make sure you get the correct test done and the correct diet and supplements recommended.

  3. Avatar
    April November 17, 2016 at 9:50 pm - Reply

    Fits me perfectly. The visceral hypersensitivity can be pretty bad. What is normal motility for most people is pain for me.

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    youjizz December 5, 2019 at 4:41 pm - Reply

    Irritable bowel syndrome (IBS) is a complex, functional gastrointestinal disorder characterized by chronic abdominal pain or discomfort and altered bowel habits. Despite the global prevalence and disease burden of IBS, its underlying pathophysiology remains unclear. Inflammation may play a pathogenic role in IBS. Studies have highlighted the persistence of mucosal inflammation at the microscopic and molecular level in IBS, with increased recruitment of enteroendocrine cells. Substantial overlaps between IBS and inflammatory bowel disease have also been reported. This review thus aimed to discuss the body of evidence pertaining to the presence of mucosal inflammation in IBS, its putative role in the disease process of IBS, and its clinical relevance. Increased mast cell density and activity in the gut may correlate with symptoms of visceral hypersensitivity. As evidenced by patients who develop postinfectious IBS, infective gastroenteritis could cause systemic inflammation and altered microbiome diversity, which in turn perpetuates a cycle of chronic, low-grade, subclinical inflammation. Apart from mucosal inflammation, neuroinflammation is probably involved in the pathophysiology of IBS via the gut brain axis, resulting in altered neuroendocrine pathways and glucocorticoid receptor genes. This gives rise to an overall proinflammatory phenotype and dysregulated hypothalamic pituitary adrenal axis and serotonergic (5-HT) functioning, which could, at least in part, account for the symptoms of IBS. Although a definite and reproducible pattern of immune response has yet to be recognized, further research into anti-inflammatories may be of clinical value.

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