Gut—brain interactions in IBD: a clinician’s perspective

  • T. M. Bayless


While most physicians, and some patients, consider psychosocial factors as important in aggravating the symptoms of already existing IBD, most of the information is based on varied anecdotal observations and bolstered by a few recent scientific studies. However, a belief in an association between the mind and IBD is tempered by a tendency for patients and some physicians to view psychosocial and stress-related issues with speculation, bias and some stigmatization. On the positive side, patients with proctitis who have experienced recrudescence of mucosal friability and rectal bleeding within a day of a severe life stress provide a dramatic example of such ‘hard-to-dismiss’ anecdotes. While psychosocial factors may not initiate inflammation in IBD, it is possible that they lead to alterations in the immune response and thereby alter disease activity. Thus, impulses started in the brain may act as aggravating factors for already-established bowel inflammation, rather than as primary causative factors.


Inflammatory Bowel Disease Ulcerative Colitis Irritable Bowel Syndrome Psychosocial Factor Enteric Nervous System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Mitchell CM, Drossman DA. Survey of the AGA membership relating to patients with functional gastrointestinal disorders. Gastroenterology. 1987;92:1282–4.PubMedGoogle Scholar
  2. 2.
    Wood JD. Enteric neuroimmune interactions. In: Walker WA, Harmatz PR, Wershil BK, editors. Immunophysiology of the gut. New York: Academic Press; 1993.Google Scholar
  3. 3.
    Drossman DA. Psychosocial considerations in gastroenterology. In: Sleisenger MH, Fordtran JS, Cello JP, Feldman M, editors. Gastrointestinal disease: pathophysiology, diagnosis, management. Philadelphia: Saunders; 1993:3–17.Google Scholar
  4. 4.
    Drossman DA, Sandler RS, McKee DC, Lovitz AJ. Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction. Gastroenterology. 1982;83:529–34.PubMedGoogle Scholar
  5. 5.
    Mayer EA, Raybould HE. Role of visceral afferent mechanisms in functional bowel disorders. Gastroenterology. 1990;99:1688–704.PubMedGoogle Scholar
  6. 6.
    Porter RW, Brady JV, Conrad D, Mason JW, Calambos R, Rioch D. Some experimental observations on gastrointestinal lesions in behaviorally conditioned monkeys. Psychosom Med. 1958;20:379–94.PubMedGoogle Scholar
  7. 7.
    Stout C, Snyder RL. Ulcerative colitis-like lesions in Siamang gibbons. Gastroenterology. 1969;57:256–60.PubMedGoogle Scholar
  8. 8.
    Engel GL. Psychological factors in ulcerative colitis in man and gibbon. Gastroenterology. 1969;57:362–4.PubMedGoogle Scholar
  9. 9.
    Drossman DA. Is the cotton-topped tamarin a model for behavioral research? Dig Dis Sci. 1985;30:24–7S.CrossRefGoogle Scholar
  10. 10.
    North CS, Alpers DH, Helzer JE, Spitznagel EL, Clouse RE. Do life events or depression exacerbate inflammatory bowel disease? Ann Intern Med. 1991;114:381–6.PubMedGoogle Scholar
  11. 11.
    Duffy LC, Zielezny MA, Marshall JR et al. Relevance of major stress events as an indicator of disease activity prevalence in inflammatory bowel disease. Behav Med. 1991;17:101–10.PubMedCrossRefGoogle Scholar
  12. 12.
    Garrett VD, Brantly PJ, Jones GN, McKnight GT. The relation between daily stress and Crohn’s disease. J Behav Med. 1991;14:87.PubMedCrossRefGoogle Scholar

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© Kluwer Academic Publishers and Axcan Pharma, Inc. 1994

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  • T. M. Bayless

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