Anxiety-Depression Disorder Aggravates Digestive Symptoms in IBS Patients

In a study published in Experimental and Therapeutic Medicine, a professor in the Department of Digestive System at Xingtai People's Hospital in China, investigated the correlation between psychological status and the mechanism of action of pro-inflammatory and anti-inflammatory cytokines in patients with diarrhea-predominant irritable bowel syndrome (IBS-D).

In a study published in Experimental and Therapeutic Medicine, a professor in the Department of Digestive System at Xingtai People’s Hospital in China, investigated the correlation between psychological status and the mechanism of action of pro-inflammatory and anti-inflammatory cytokines in patients with diarrhea-predominant irritable bowel syndrome (IBS-D).

For his research entitled “Correlation between Anxiety-Depression Status and Cytokines in Diarrhea-Predominant Irritable Bowel Syndrome,” Jingguo Gao compared self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores — as well as levels of cytokines Interleukin-10 (IL-10) and Interleukin-1 beta (IL-1β) in blood and sigmoid colon mucosa samples — from 12 IBS-D patients with normal psychological status to 16 IBS-D patients with anxiety-depression disorder against 15 control subjects with neither digestive symptoms nor psychological symptoms.

The results of those analyses demonstrated that among the two IBS-D groups and the control group, “SDS and SAS scores in the IBS-D group were significantly higher than those in the control group (P<0.05),” Gao wrote.

Comparing IL-10 and IL-1β levels between the IBS and control groups, Gao found that the levels of the pro-inflammatory cytokine IL-1β in the IBS-D patients were significantly higher than those in the control group, while the levels of the anti-inflammatory cytokine IL-10 in the IBS-D group were significantly lower than those in the control subjects.

Examining the cytokine levels between IBS-D patients with anxiety-depression and those without the mix of psychiatric disorders, Gao discovered that “IL-1β in the blood and sigmoid colon mucosa in the anxiety-depression IBS-D group were significantly higher than those in the non-anxiety-depression IBS-D group, (while) the levels of IL-10 in the blood and sigmoid colon mucosa in the anxiety-depression IBS-D group were significantly lower than those in the non-anxiety-depression IBS-D group.” Measuring the proportions of IL-1β-positive cells and IL-10-positive cells in the blood and colon mucosa samples across the three patient groups, Gao found the same results.

Reviewing all of his study findings, Gao concluded that “anxiety-depression status may cause changes in the IL-1β and IL-10 levels of IBS patients, resulting in an imbalance of the pro-inflammatory and anti-inflammatory cytokines, leading to the occurrence or aggravation of IBS.”

“Cytokines, inflammatory reactions, and psychological factors all play important roles in the development of IBS,” Gao wrote. “Psychological factors lead to variations in the levels of cytokines and the balance between anti-inflammatory and pro-inflammatory factors, resulting in the aggravation of IBS or digestive symptoms; whereas the aggravation of somatic symptoms exacerbates psychological burden and anxiety-depression symptoms, exhibiting a close interactive correlation.”