Depressive symptoms in inflammatory bowel disease: An extraintestinal manifestation of inflammation

This 2019 review outlines how dysregulation of the gut-brain axis (the bidirectional communication between gut and brain) in irritable bowel disease patients may lead to further inflammation and depression, resulting in a vicious cycle of worsening irritable bowel disease outcomes. Since the intestinal microbiota is closely linked with host immune responses, Moulton et al. explain that patients prone to shifts in their intestinal microbiome, including smokers, those with poor diet and early life stress, may be exposed to exaggerated immune responses. Excess inflammation is associated with brain changes (depressive symptoms, fatigue, sleep difficulties) and worsening gastrointestinal symptoms, which are exacerbated by psychological distress. While there are treatments for depression and irritable bowel disease that are designed to reduce inflammation and break this cycle already, the researchers suggest the modification of microbiota composition as another strategy that may reduce depressive symptoms. [NPIDs: gastrointestinal disorders, gut-brain axis, IBD, inflammation, depression, smoking, early life stress, the immune system, fatigue, stress, psychological stress]

Year: 2019

Reference: Moulton, C. D., Pavlidis, P., Norton, C., Norton, S., Pariante, C., Hayee, B., & Powell, N. (2019). Depressive symptoms in inflammatory bowel disease: an extraintestinal manifestation of inflammation?. Clinical and experimental immunology, 197(3), 308–318. https://doi.org/10.1111/cei.13276