Irritable Bowel Syndrome Symptoms in Nonalcoholic Fatty Liver Disease Patients Are an Indicator of Depression and Anxiety

Abstract

Goals: Determine factors associated with Irritable bowel syndrome (IBS) in nonalcoholic fatty liver disease (NAFLD) patients. Background: IBS affects 10% to 15% of the adult population worldwide and is linked to anxiety and depression. The impact of IBS-type symptoms in NAFLD patients is not well described. Study: A cross-sectional study of patients in the hepatology clinic at Houston Methodist Hospital was performed based on a respondent postal survey. IBS was defined by the Rome IV questionnaire, anxiety and depression were assessed with the Hospital Anxiety Depression scale. Patients with inflammatory bowel disease, colorectal carcinoma, or small bowel tumors were excluded. Patients were divided based on Rome IV diagnostic criteria for IBS and Hospital Anxiety Depression scale. Results: 130 patients were included in the analysis, 38 satisfied Rome IV criteria for IBS (IBS group) versus 92 who did not (non-IBS group). Depression was more prevalent in the IBS group (18.4% vs 5.4%, P=0.01). Anxiety was also greater in the IBS group (31.6% vs 9.8%, P=0.002). Female sex, depression, and body mass index (BMI)>30 were independent predictors of IBS in NAFLD in 4 multiple logistic regression models. In newly diagnosed IBS patients, gamma-glutamyl transferase levels were lower (67.5 vs 28, P=0.04). Current abdominal pain was higher than 100% versus 81.3% (P=0.045), as was pain associated with the change in stool frequency (96.3% vs 50%; P<0.001). Conclusion: Our study highlights the increased rate of IBS symptoms, depression, and anxiety in patients with NAFLD. Clinicians should be alert when IBS symptoms are reported by a NAFLD patient and be aware of the impact of these comorbidities on quality of life and response to therapy.

IBS phenotype associated with obesity and overweight: treatment tactics for patient-centered management

“…В зарубежной литературе описана более высокая частота встречаемости симптомов СРК, депрессии и тревоги у пациентов с НАЖБП [33]. Так, в проспективном когортном исследовании с участием 396 838 человек из 22 центров в Англии, Уэльсе и Шотландии риск возникновения СРК у пациентов, страдающих НАЖБП, на 13% превышал риск возникновения СРК у лиц без НАЖБП [34].…”

“…Формирование НАЖБП и СРК ассоциировано с рядом общих факторов риска и патофизиологических механизмов, включая особенности питания, изменение состава кишечной микробиоты, повышение проницаемости эпителиального барьера кишечника, нарушение нейрогуморальной регуляции, системное воспаление [33][34][35].…”

Study of Interrelationship Between Irritable Bowel Syndrome and Non-Alcoholic Fatty Liver Disease

“…Higher body mass indexes have been linked to rapid colonic and recto sigmoid transit durations as well as more frequent stools [20]. Increased insulin resistance is regarded to be the primary factor in the pathophysiology of Non-alcoholic fatty liver disease (NAFLD), and excess adipose tissue is also likely to contribute to liver deposition by exhausting peripheral storage capacity [21]. Non-alcoholic fatty liver disease (NAFLD), or steatosis, is a range of liver disorders linked to obesity that may or may not include inflammation and fibrosis (also called steatohepatitis).…”

Non-Alcoholic Fatty Liver Disease (NAFLD): Molecular Mechanism, Pathological Progression and Treatment

“…when it does, they could consist of fatigue, aches and pains in the upper right abdomen [112]. While in NASH and severe scarring (cirrhosis) could show these symptoms, stomach bloating (ascites), bigger blood vessels under the skin's surface and exaggerated spleen [113]. Regarding clinical finding of NAFLD, serum TG and TC levels were higher in the HFD group than in the normal diet group, at the same time LDL level was higher in the HFD group than in the normal diet group.…”