There is a considerable comorbidity between anxiety/depression and functional gastrointestinal syndromes, like irritable bowel syndrome (IBS) and functional dyspepsia. The pathophysiological link between emotions and the gut is not known. A model of an emotional motor system (EMS) that responds to interoceptive and exteroceptive stress has been proposed. EMS includes particular brain structures including anterior cingulate cortex (ACC), amygdala, hippocampus and hypothalamus and mediates their communication with the remaining portion of the body (including the gastrointestinal tract) through the hypothalamus-pituitary-adrenal (HPA) axis, the autonomic nervous system (ANS) and by a pain modulation system. The purpose of this dissertation ended up being to test the EMS model by examining the relationship between symptoms of anxiety and depression and IBS-like symptoms in patients with repeated unipolar depression, in patients with IBS…
Contents
BACKGROUND
Irritable bowel syndrome (IBS)
Abnormal Motility in Patients with IBS
Visceral Hypersensitivity in IBS
Inflammation and infection in IBS
Food intolerance and IBS
IBS and comorbidity
IBS and affective disorders
Brain-Gut Interactions in IBS
The Emotional motor system (EMS)
Corticotropin releasing hormone (CRH)
The Hypothalamic-Autonomic Nervous System (ANS) axis
The Hypothalamic-Pituitary-Adrenal (HPA) axis
Changes in pain modulation
Val158Met COMT Polymorphism
AIMS
Specific aims
PATIENTS AND METHODS
Study cohorts
Questionnaires
Medical records
Functional test on HPA axis suppression
Spectral analysis of heart rate variability
Val158met COMT
Statistics
Ethics
RESULTS AND COMMENTS
Anxiety/Depression and Gastrointestinal symptoms
ANS and IBS
Hippocampal-HPA axis and Gastrointestinal symptoms
Catechol-O-Methyltransferase (COMT) and IBS…
Source: Umea University