There is a strong link between IBS and psychological disorders anxiety, depression

Are you prone to anxiety and do you suffer from recurrent stomach pain, diarrhoea or constipation? You could have irritable bowel syndrome (IBS), a common chronic condition linked to psychological disorders such as anxiety and depression.

IBS affects the large intestine or colon, which is the last portion of the digestive tract. If you have IBS, your bowel movements may be stronger or slower than normal.

“While there are multiple factors leading to irritable bowel syndrome, there is a strong association with psychological disorders such as anxiety and depression. However, it is not always clear whether the anxiety or depression causes IBS or results from the IBS symptoms,” says Dr Wang Yu Tien, Consultant, Department of Gastroenterology & Hepatology, Singapore General Hospital (SGH), a member of the SingHealth group.

“IBS is a common condition that affects 9 per cent of the population in Singapore. In some other countries it can affect up to 20 per cent,” he adds.

IBS can affect people of any age but it has been found to be more common in those aged 20-30.

Symptoms of irritable bowel syndrome (IBS)

The symptoms of IBS range from mild to severe. They are:

  • Stomach pain or cramping
  • Diarrhoea
  • Constipation
  • Incomplete bowel clearance
  • Bloating
  • Gas
  • Mucus in the stool

Other less common symptoms include tiredness, backache, urinary frequency, and poor sleep.

For the vast majority of patients, the symptoms are quite mild and don’t require treatment. However chronic recurrent symptoms can cause discomfort and inconvenience which adversely affect quality of life, says Dr Wang.

Diagnosis of IBS is based on the patient’s medical history as well as routine tests. A patient who suffers from abdominal pain or discomfort associated with altered bowel habits is diagnosed with IBS when routine tests such as blood tests, scans and endoscopy fail to detect any other problem.

Patients who have other symptoms such as blood in the stools and unexplained weight loss may require further investigation to rule out more serious conditions such as colon cancer.

Risk factors of IBS

The exact cause of IBS is unknown. However, a combination of physiological and psychological factors may play a role in its development. These risk factors include:

  • Overly sensitive nerves in the colon
  • Abnormalities in the nervous system or colon
  • Food intolerances
  • Bacterial overgrowth or unfriendly bacteria in the gut
  • Anxiety
  • Depression

The link between anxiety, depression and IBS

There is a strong link between IBS on the one hand, and anxiety and depression on the other hand. However, it is unclear which one comes first.

“Psychological disorders can affect the way we perceive discomfort coming from the intestinal tract,” says Dr Wang.

A study carried out by SGH found that almost half of 345 IBS patients screened from November 2010 to October 2011 had psychological disorders.

The most common psychological disorder associated with IBS is anxiety, followed by depression.

“We now screen all our severe IBS patients for psychological disorders. When we find a psychological disorder we refer the patient to a psychiatrist or psychologist for intervention,” says Dr Wang.

“Understanding this condition can give patients the reassurance to live with this condition. A lot of patients want reassurance that this is not cancer,” he adds.

Read on to find out about management tips and treatment options available for IBS.

Ref: S13