Colonoscopy: body and psyche. Can psychiatry contribute to the quality of the examination?

Abstract

Introduction: The relationship between a state of a body and mind is well known, although difficult to grasp. Its existence is reflected in subsequent editions of the classifications of mental disorders. One important and frequently performed medical procedure that significantly interferes with the patient's somatic state is colonoscopy. The aim of this study was to review the literature on the patient's psychological functioning in the context of colonoscopy. Material and methods: A review of literature in PubMed and Scopus databases was conducted. Keywords used were: colonoscopy, psychiatry, mental disorders, psychogastroenterology, gut-brain axis, anxiety, depression, cognitive functions, pain perception, limiting the search scope to 2013-2023. Discussion: The bidirectional relationship between psychological factors and a range of functional gastrointestinal disorders, contributed to the introduction of the term psychogastroenterology. One of its important areas is the research on the gut-brain axis. The interplay between the gut microbiome and mental functioning is apparent. Colonoscopy disrupts the composition of the intestinal microflora. However, despite its invasiveness, it is still often irreplaceable for the diagnosis and treatment of bowel diseases (including colorectal cancer). Higher adherence is needed, which could be achieved by improving patient comfort. An increased level of anxiety before the procedure and its negative impact on cognitive functioning is observed. Negative affect amplifies the experience of pain. Colonoscopy technique continues to be developed. A comprehensive description of the patient's psychological functioning in a colonoscopy situation is still lacking. Conclusions: A comprehensive description of the patient's affective and cognitive determinants in the context of colonoscopy and the associated pain and discomfort would be advisable. Keywords: psychiatry, gastroenterology, colonoscopy, gut-brain axis