2014
DOI: 10.3748/wjg.v20.i13.3552
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Abstract: Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anter… Show more

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Cited by 76 publications
(63 citation statements)
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References 123 publications
(147 reference statements)
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“…As described in this section, it is well-established that the anticholinergic effects of first and second generation antipsychotics, and clozapine in particular, contribute to and compound GI motility issues such as constipation and bowel obstruction. Interestingly, while there exists substantial GI comorbidities in schizophrenia, the reverse may also be true, as increasingly psychiatric comorbidities are being reported in individuals with GI disorders such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) and celiac disease [36][37][38][39][40]. In this section, we review the motility effects of psychiatric medications, appraise current information regarding GI inflammation in schizophrenia as an inherent disease pathology and examine the overlapping epidemiology of the autoimmune disorder, celiac disease, and other dietary-based sensitivities with schizophrenia.…”
Section: Gi Issues For Consideration By Psychiatric Cliniciansmentioning
confidence: 99%
“…This psychological distress is higher in IBD patients during active disease than during remission [9,24]. There seems to be a bidirectional relationship between stress and active disease: being symptomatic may increase stress, and psychological stress may exacerbate symptomatic disease [1,4,21]. Flare up of active disease in IBD is related to stressful life events, such as domestic stress, and high perceived stress during the previous 3 month period, as shown by a study comparing 174 IBD patients experiencing a flare to 209 IBD patients without a flare up [25].…”
Section: Psychosocial Factors Stressmentioning
confidence: 99%
“…Even in healthy people, a psychological stressor such as public speech has been shown to increase small intestinal permeability through activation of the stress axis by increasing cortisol levels [4]. This effect was dependent on mast cell activation, which has been shown to play an important role in stress related gut dysfunction, mainly through their CRF surface receptors and subsequent release of pro inflammatory mediators [1,23]. Likewise, proinflammatory cytokine Il-6 levels were found to be increased in IBD patients as compared to controls after a calculation stress test, which may contribute to the continued HPA axis stimulation, inflammatory response and possible exacerbation of IBD [26].…”
Section: Psychosocial Factors Stressmentioning
confidence: 99%
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