Multidimensionality of symptom complexes in irritable bowel syndrome and other functional gastrointestinal disorders

Alpers, David H.

doi:10.1016/j.jpsychores.2008.02.023

Cited by 17 publications

(16 citation statements)

References 32 publications

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“…Others have referred to a dual aetiology hypothesis whereby IBS patients can be divided into those with an excessive number of bodily symptoms – a psychological aetiology group – and the remainder who are presumed to have a biological aetiology 5. It is not known whether the additional bodily symptoms, outside the GI tract, are part of, or distinct from, the processes that lead to the GI symptoms6 7 but we should try to remember that body and mind work together, not separately. Recent studies have demonstrated that both exposure to infection and psychological variables interact in post-infective IBS and a high somatisation score at the time of gastroenteritis predicts later IBS 8 9…”

Section: Dualismmentioning

confidence: 99%

Somatisation in functional dyspepsia: integrating gastric physiology with psychological state

Creed

2008

Gut

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Functional dyspepsia is considered to be the result of a complex interaction between biological, psychological and social factors. In this issue of the journal, Van Oudenhove and colleagues 1 (see page 1666) are the first to (1) present a study reporting these three aspects simultaneously in a large sample of patients attending a tertiary clinic and (2) identify whether the symptoms of functional dyspepsia are more closely associated with measures of gastric function or psychological state. The study suggests strongly it is the latter.In a sound, cross-sectional study of 201 patients the authors correlated responses to gastric distension with measures of past and recent stress, anxiety, depression and a measure of somatisation with the gastrointestinal items removed. In multivariate analysis, including all these independent measures, somatisation was the only significant correlate of number and severity of dyspeptic symptoms. Somatisation and reported childhood abuse were the only significant correlates of weight loss. These relationships were similar in people who were, or were not, hypersensitive to gastric distension.Has this study really advanced our knowledge of the aetiology of functional dyspepsia? There are several difficulties with the design of this study which limit its usefulness in this respect, even though it was executed well. These include the choice of endpoints, the cross-sectional design and the dualistic approach.

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Section: Dualismmentioning

confidence: 99%

Somatisation in functional dyspepsia: integrating gastric physiology with psychological state

Creed

2008

Gut

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“…As discussed by Alpers, whether comorbidities in IBS represent part of the clinical manifestations, are distinct from IBS and other functional gastrointestinal disorders, or if they are part of the somatization, remains to be elucidated (21). For example, a study among five hundred and fifty patients in London showed that IBS, tension headache, fibromyalgia, non ulcer dyspepsia, hyperventilation and non-cardiac chest pain were likely to overlap with one another and they confirmed that each functional disorder does not exist independently but instead from clusters (22).…”

Section: Discussionmentioning

confidence: 99%

Heartburn and other related symptoms are independent of body mass index in irritable bowel syndrome

Schmulson¹,

Pulido²,

Escobar³

et al. 2010

Rev. esp. enferm. dig.

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Background: increasing body mass index (BMI) is a risk factor for GERD but little is known about this association in the irritable bowel syndrome (IBS).Aims: to determine the presence of heartburn and other related symptoms in relation with BMI in IBS.Methods: volunteers (n = 483) answered the Rome II-Modular Questionnaire, and were divided into IBS and non-IBS (controls) groups. The frequency of heartburn, chest pain, epigastric pain, nausea, vomiting and belching was compared between the groups in the study sample and within three BMI categories.Results: the IBS (23.7%) and controls (76.3%) were similar in gender (females: 68.1%), age (32.2 ± 12.7 years), and BMI (25.4 ± 4.4). Raw associations analysis showed that heartburn: OR: 1.62 (95%CI: 1.04-2.53), chest pain: 1.77 (1.13-2.77), epigastric pain: 1.75 (1.03-2.98) and nausea: 2.45 (1.10-5.32) were more frequent in IBS vs. controls. Meanwhile, according to BMI, in those with obesity, heartburn was more frequent in IBS and among those with overweight, epigastric pain and nausea were also more frequent in IBS. However, in an adjusted log linear model, no significant interaction was found between BMI and any other studied symptom and heartburn was found to be independent of IBS: 1,4 (0.9, 4.7). Finally, a logistic regression model found no interaction between BMI and the presence of heartburn or IBS.Conclusions: while heartburn and other reflux-related symptoms are more frequent in IBS than in controls, these associations are independent of BMI.

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“…Esses critérios ainda são extremamente específicos e centrados na dor e desconforto abdominal e alterações do hábito intestinal 7 . Os fatores psicossociais relacionados à severidade dos sintomas da SII devem ser considerados na clínica e nas futuras atualizações dos critérios diagnósticos.…”

Section: Tabelaunclassified

“…Porém, sintomas extraintestinais como cefaleias, so-nolência, mal-estar e comorbidades psiquiátricas, frequentemente encontrados em pacientes com SII, embora ainda não considerados nos critérios diagnósticos de Roma, sinalizam a importância da somatização na etiologia dessa doença 7 .…”

Section: Introductionunclassified

Influência da resposta individual ao estresse e das comorbidades psiquiátricas na síndrome do intestino irritável

Ribeiro¹,

Alves²,

Silva-Fonseca³

et al. 2011

Rev. psiquiatr. clín.

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ResumoContexto: A síndrome do intestino irritável (SII) é um distúrbio clínico comum, porém ainda pouco compreendida, uma vez que o desenvolvimento dos seus sintomas está fortemente relacionado ao estresse, ansiedade e depressão. Objetivos: Revisar a literatura a fim de verificar se, de fato, existe influência do estresse e das comorbidades psiquiátricas no desenvolvimento, diagnóstico e tratamento para os portadores da SII. Métodos: A revisão foi realizada por meio de pesquisa na base de dados MedLine e Lilacs entre 1990 e 2009, usando-se as palavras-chave "estresse", "comportamento", "psiquiatria" e "síndrome do intestino irritável". Resultados: Foram selecionados 38 artigos que relacionaram a síndrome do intestino irritável à reação individual ao estresse e comorbidade psiquiátrica, incluindo ansiedade e depressão. Conclusão: A reatividade do indivíduo ao estresse e os fatores psicossociais desempenham um papel etiológico importante, embora não determinante, podendo interferir no funcionamento intestinal mediante a alteração na motilidade ou espasmo, na diminuição ou aumento de secreção e, finalmente, na irritação. É necessário desenvolver uma metodologia para definir e medir a somatização para o auxílio no diagnóstico clínico e a inclusão dos fatores psicossociais relacionados ao desenvolvimento e persistência dos sintomas nos critérios diagnósticos para a SII.Ribeiro LM, et al. / Rev Psiq Clín. 2011;38(2):77-83 Palavras-chave: Síndrome do cólon irritável, tratamento, estresse, comportamento. AbstractBackground: The irritable bowel syndrome (IBS) is a common clinical disorder, however, still poorly understood since the development of symptoms is strongly

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Multidimensionality of symptom complexes in irritable bowel syndrome and other functional gastrointestinal disorders

Cited by 17 publications

References 32 publications

Somatisation in functional dyspepsia: integrating gastric physiology with psychological state

Somatisation in functional dyspepsia: integrating gastric physiology with psychological state

Heartburn and other related symptoms are independent of body mass index in irritable bowel syndrome

Influência da resposta individual ao estresse e das comorbidades psiquiátricas na síndrome do intestino irritável

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