Riassunto
Questo capitolo prende in considerazione le interazioni tra stress psicofisico e disturbi funzionali digestivi. Questi ultimi rappresentano una famiglia di affezioni disfunzionali ad alta prevalenza nella popolazione generale, causa di morbilità e di costi sociosanitari assai rilevanti, a fronte di una completa negatività (per definizione) degli esami di laboratorio o anatomo-morfologici. Per tale ragione, i disturbi funzionali digestivi (DFD) sono spesso considerati disturbi virtuali, cioè presenti solo nella “testa” dei pazienti, e pertanto sono trascurati dalla maggior parte dei gastroenterologi e dei medici di medicina generale, con il risultato di mantenere alta nel paziente l’espressione sintomatica e la sofferenza, perpetuando peraltro lo stress psicologico, legato alla mancata comprensione del disturbo.
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Bibliografia
Drossman DA (2006) The functional gastrointestinal disorders and the Rome III process. Gastroenterology 130:1377–1390
Cryan JF, O’Mahony SM (2011) The microbiome-brain-gut axis: from bowel to behaviour. Neurogastroenterol Motil 23:187–192
Grant Thompson W (2006) The road to Rome. Gastroenterology 130:1552–1556
Chang L (2011) The role of stress on physiologic responses and clinical symptoms in irritable bowel syndrome. Gastroenterology 140:761–765
McEwen BS (1998) Protective and damaging effects of stress mediators. N Engl J Med 338:171–179
Whitehead WE, Palsson O, Jones KR (2002) Systemic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology 122:1140–1156
Mayer EA. Gut feelings (2011) The emerging biology of gut-brain communication. Nature review: neuroscience 12:453–466
Lightman SL (2008) The neuroendocrinology of stress: a never ending story. J Neuroendocrinol 20:880–884
Levy RL, Olden KW, Naliboff BD et al (2006) Psychosocial aspects of functional gastrointestinal disorders. Gastroenterology 130:1447–1458
Drossman DA (2011) Abuse, trauma and GI illness: is there a link? Am J Gastroenterol 106:14–25
Ross CA (2005) Childhood sexual abuse and psychosomatic symptoms in irritable bowel syndrome. J Child Sex Abus 14:27–38
Drossman DA, Li Z, Leserman J et al (1996) Health status by gastrointestinal diagnosis and abuse history. Gastroenterology 110:999–1007
Ringel Y, Drossman DA, Leserman JL et al (2008) Effect of abuse history on pain reports and brain responses to aversive visceral stimulation: an fMRI study. Gastroenterology 134:396–404
Morgan V, Pickens D, Gautam S et al (2005) Amitriptyline reduces rectal painrelated activation of the anterior cingulate cortex in patients with irritable bowel syndrome. Gut 54:601–607
Lackner JM, Coad ML, Mertz HR et al (2006) Cognitive therapy for irritable bowel syndrome is associated with reduced limbic activity, GI symptoms, and anxiety. Behav Res Ther 44:621–638
Mayer EA (2000) The neurobiology of stress and gastrointestinal disease. Gut 47:861–869
Gwee KA, Leong YL, Graham C et al (1999) The role of psychological and biological factors in postinfective gut dysfunction. Gut 44:400–406
Tachè Y, Bonaz B (2007) Corticotropin-releasing factor receptors and stress-related alterations of gut motor function. J Clin Invest 117:33–40
Bale TL (2005) Sensitivity to stress: dysregulation of CRF pathways and disease development. Horm Behav 48:1–10
Lupien SJ, McEwen BS, Gunnar MR et al (2009) Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci 10:434–445
Hillhouse EW, Grammatopoulos DK (2006) The molecular mechanisms underlying the regulation of the biological activity of corticotropin-releasing hormone receptors: implications for physiology and pathophysiology. Endocr Rev 27:260–286
Ising M, Zimmermann US, Kunzel HE et al (2007) High-affinity CRF1 receptor antagonist NBI-34041: preclinical and clinical data suggest safety and efficacy in attenuating elevated stress response. Neuropsychopharmacology 32:1941–1949
Holsboer F, Barden N (1996) Antidepressants and hypothalamicpituitary-adrenocortical regulation. Endocr Rev 17:187–205
Stengel A, Taché Y (2009) Neuroendocrine control of the gut during stress: corticotropin-releasing factor signaling pathways in the spotlight. Annu Rev Physiol 71:219–239
Nakade Y, Fukuda H, Iwa M et al (2007) Restraint stress stimulates colonic motility via central corticotropin-releasing factor and peripheral 5-HT3 receptors in conscious rats. Am J Physiol Gastrointest Liver Physiol 292:G1037–G1044
Welgan P, Meshkinpour H, Hoehler F (1985) The effect of stress on colon motor and electrical activity in irritable bowel syndrome. Psychosom Med 47:139–149
Fukudo S, Nomura T, Hongo M (1999) Impact of corticotropin-releasing hormone on gastrointestinal motility and adrenocorticotropic hormone in normal controls and patients with irritable bowel syndrome. Gut 42:845–849
Posserud I, Agerforz P, Ekman R et al (2004) Altered visceral perceptual and neuroendocrine response in patients with irritable bowel syndrome during mental stress. Gut 53:1102–1108
Dickhaus B, Mayer EA, Firooz N et al (2003) Irritable bowel syndrome patients show enhanced modulation of visceral perception by auditory stress. Am J Gastroenterol 98:135–143
Murray CD, Flynn J, Ratcliffe L et al (2004) Effect of acute physical and psychological stress on gut autonomic innervation in irritable bowel syndrome. Gastroenterology 127:1695–1703
Mertz H, Naliboff B, Munakata J et al (1995) Altered rectal perception is a marker of patients with irritable bowel syndrome. Gastroenterology 109:40–52
Dunlop SP, Hebden J, Campbell E et al (2006) Abnormal intestinal permeability in subgroups of diarrhea-predominant irritable bowel syndromes. Am J Gastroenterol 101:1288–1294
Larauche M, Kiank C, Tache Y (2009) Corticotropin releasing factor signaling in colon and ileum: regulation by stress and pathophysiological implications. J Physiol Pharmacol 60:33–46
Alonso C, Guilarte M, Vicario M et al (2008) Maladaptive intestinal epithelial responses to life stress may predispose healthy women to gut mucosal inflammation. Gastroenterology 135:163–172
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Pace, F., Pace, M., Biasini, D. (2012). Stress e disturbi funzionali digestivi. In: Stress e disturbi da somatizzazione. Springer, Milano. https://doi.org/10.1007/978-88-470-2080-1_9
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DOI: https://doi.org/10.1007/978-88-470-2080-1_9
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