Depression linked to bowel conditions

Depression is more common among people with inflammatory bowel diseases or IBD.

A new study, which studied the records of fifteen thousand people with ulcerative colitis and Crohn’s disease, collectively known as inflammatory bowel diseases or IBD, examined the link between depression and the chance of later developing IBD. Scientists found that patients were more likely to be diagnosed with depression as long as nine years before diagnosing their IBD.

The study was conducted by scientists from the St George’s University of London in collaboration with Imperial College London, University College London, and King’s College London.

Inflammatory bowel disease (IBD) is a term for two conditions (Crohn’s disease and ulcerative colitis) that are characterized by chronic inflammation of the gastrointestinal (GI) tract. IBD can result in abdominal pain, diarrhea, or rectal bleeding.

People who reported gastrointestinal symptoms before developing depression were 40% more likely to develop IBD compared with people without depression. However, individuals with depression, but no prior gastrointestinal symptoms were no more likely to be diagnosed with IBD than individuals without depression.

Study author Dr. Jonathan Blackwell from Imperial’s School of Public Health and the St George’s University of London explained: “The relationship between depression and IBD is unclear, but it is likely some individuals develop depression as a consequence of gastrointestinal symptoms they experience before being diagnosed with IBD. If you are experiencing Depression with abdominal pain, diarrhea, or rectal bleeding, see your doctor and get tested because there may be a treatable cause.”

Professor Sonia Saxena, the study co-author from Imperial’s School of Public Health, said: “The main message for GPs and clinicians is to think holistically when patients report feeling anxious or depressed in the presence of diarrhea, abdominal pain or rectal bleeding – could all these things be related to an underlying condition such as inflammatory bowel disease?”

“Extra vigilance is needed during the pandemic because the usual cues for low mood anxiety or depression are hard to detect over the phone and easy to pass off as being related to the current global crisis.”

Professor Richard Pollok, a study co-author from the St George’s University of London, added“It is possible people become depressed while living with undiagnosed gut symptoms of Crohn’s disease or ulcerative colitis. Now, more than ever, during the COVID-19 pandemic, it is vital to put strategies in place to ensure timely diagnosis of these bowel conditions to protect people’s physical and mental health.”

Depression is not a risk factor for developing IBD; however, people with depression and previous gastrointestinal symptoms may be more likely to develop either Crohn’s disease or ulcerative colitis.

Journal Reference:
  1. Blackwell J, Saxena S, Petersen I, et al. Depression in individuals who subsequently develop inflammatory bowel disease: a population-based nested case-control study, Gut Published Online First: 27 October 2020. DOI: 10.1136/gutjnl-2020-322308

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