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The Interaction between Stress and Inflammatory Bowel Disease in Pediatric and Adult Patients
Oana Belei1,2, Diana-Georgiana Basaca1,2, Laura Olariu2
1First Pediatric Clinic, Disturbances of Growth and Development on Children Research Center, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Insights
Psychological stress significantly impacts inflammatory bowel diseases (IBD) progression. Managing stress is crucial for IBD patients, alongside medical treatments, to reduce disease flares and improve outcomes.
Area of Science:
- Gastroenterology
- Psychoneuroimmunology
- Inflammatory Bowel Diseases
Background:
- Inflammatory bowel diseases (IBD) incidence is rising, especially in children.
- Psychological stress is a key factor affecting IBD disease course and severity.
Purpose of the Study:
- To review the scientific literature on the interaction between stress and IBD progression.
- To focus on studies quantifying inflammatory markers in IBD patients experiencing psychological stress.
Main Methods:
- Systematic narrative literature review.
- Searched PubMed, Scopus, Medline, and Cochrane Library (2000-2023).
- Included adult, pediatric, and animal IBD studies.
Main Results:
- The gut-brain axis mediates IBD pathophysiology; stress increases gut permeability and bacterial translocation.
- Increased gut microbial load exacerbates inflammation and cytokine production, worsening IBD.
- IBD patients have higher risks of depression and anxiety; stress triggers acute disease flares.
Conclusions:
- Further research is needed to fully understand the impact of stress and psychological disorders on IBD.
- Clinicians should integrate stress-reduction strategies into IBD management alongside pharmacological therapies.
Abstract:
Background: Inflammatory bowel diseases (IBDs) have seen an exponential increase in incidence, particularly among pediatric patients. Psychological stress is a significant risk factor influencing the disease course. This review assesses the interaction between stress and disease progression, focusing on articles that quantified inflammatory markers in IBD patients exposed to varying degrees of psychological stress. Methods: A systematic narrative literature review was conducted, focusing on the interaction between IBD and stress among adult and pediatric patients, as well as animal subjects. The research involved searching PubMed, Scopus, Medline, and Cochrane Library databases from 2000 to December 2023. Results: The interplay between the intestinal immunity response, the nervous system, and psychological disorders, known as the gut-brain axis, plays a major role in IBD pathophysiology. Various types of stressors alter gut mucosal integrity through different pathways, increasing gut mucosa permeability and promoting bacterial translocation. A denser microbial load in the gut wall emphasizes cytokine production, worsening the disease course. The risk of developing depression and anxiety is higher in IBD patients compared with the general population, and stress is a significant trigger for inducing acute flares of the disease. Conclusions: Further large studies should be conducted to assess the relationship between stressors, psychological disorders, and their impact on the course of IBD. Clinicians involved in the medical care of IBD patients should aim to implement stress reduction practices in addition to pharmacological therapies.
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