Psychiatric comorbidity in patients of Irritable Bowel Syndrome

BACKGROUND: Irritable bowel syndrome (IBS) is a chronic psycho-physiological disorder, considered to be the most common functional gastrointestinal disorder. About 50–90% of IBS patients have associated psychiatric co-morbidity.It is also well-established that patients with IBS have higher levels of anxiety and depression compared to controls. AIM-: To contribute in the literature of relationship between IBS and psychiatric diseases. METHODS: A 50 y/o female patient was brought to psychiatry opd with chief complaints of:- · Multiple episodes of constipation, with mild abdominal pain; · Repetitive urges to evacuate manually, by fingers, if not done patient becoming restless, around 30-40 times a day. · Restlessness when not allowed to evacuate manually. Patient was diagnosed as IBS-C 8 years back, and since 3 years was having the above mentioned symptoms. The patient was treated on the lines of OCD spectrum and anxiety. Supportive counseling was done and patient was prescribed T. Escitalopram 10mg and T. Clonazepam as and when required. RESULTS-: There was significant improvement in urge to evacuate manually within 2-3 months of treatment in both OCD, anxiety and IBS. CONCLUSION: IBS pathophysiology is not well understood; however, it is hypothesized to be a disorder of the “gut-microbiota-brain axis”. Dysfunction in some of these pathways have been implicated in IBS and in psychiatric disorders. Anxiety is prominent component of other disorders like OCD. While several lines of evidence suggest that the gut-brain axis might be relevant to OCD, the relationship between OCD and IBS is less explored Acknowledgements Dr. Minakshi Parikh (Professor and Head, Department of Psychiatry, B.J. Medical College and Civil Hospital, Ahmedabad) Dr. Sarandha Srivastava (Assistant Professor, Department of Psychiatry, B.J. Medical College and Civil Hospital, Ahmedabad) REFERENCES: 1. Kawoos Y, Wani ZA, Kadla SA, Shah IA, Hussain A, Dar MM, Margoob MA, Sideeq K. Psychiatric Co-morbidity in Patients With Irritable Bowel Syndrome at a Tertiary Care Center in Northern India. J Neurogastroenterol Motil. 2017 Oct 30;23(4):555-560. doi: 10.5056/jnm16166. PMID: 28738451; PMCID: PMC5628988. 2. Jasmine Turna, Keren Grosman Kaplan, Beth Patterson, Premysl Bercik, Rebecca Anglin, Noam Soreni, Michael Van Ameringen, Higher prevalence of irritable bowel syndrome and greater gastrointestinal symptoms in obsessive-compulsive disorder, Journal of Psychiatric Research, https:// doi.org/10.1016/j.jpsychires.2019.08.004.