Chronic
Constipation Linked
to Anxiety and Depression
By Amy Norton
NEW YORK (Reuters
Health) - Psychological well-being is known to be intertwined
with gastrointestinal health, and new research suggests that women
with chronic constipation are more likely to be anxious or depressed
than women who don't have bowel problems.
In a study
of 34 women with chronic constipation, UK investigators linked
emotional distress with changes in the nerve pathway that helps
control gut function. They say the findings suggest a specific
path through which psychological factors directly influence the
digestive system.
Dr. Anton
Emmanuel and colleagues at St. Mark's Hospital in Middlesex report
the results in the August issue of the journal Gut.
The researchers
compared the patients--who had suffered bouts of constipation
for an average of 21 years--with a group of women with no history
of gastrointestinal illness. All took standard tests that measure
psychological symptoms such as anxiety and depression, self-image,
social functioning and ability to form intimate relationships.
They also underwent ultrasound to gauge their rectal blood flow,
a measurement of activity in nerves that run from the brain to
the gut.
Women with
chronic constipation were more likely than healthy women to report
anxiety, depression and feeling less ``feminine.'' They also found
it harder to form close relationships.
Moreover,
the investigators found that the poorer a patient's psychological
well-being was, the lower her rectal blood flow. As for healthy
women, there was no link between blood flow and psychological
factors--which, the researchers point out, was partly due to the
fact that there was little variance in these measures among healthy
women.
``We have
shown a direct demonstrable link between certain aspects of central
brain activity--anxiety, depression, feeling 'unfeminine'--and
gut dysfunction,'' Emmanuel told Reuters Health.
These findings
also echo existing evidence that patients with chronic constipation
have higher rates of depression and anxiety, according to the
researchers.
``These studies
reinforce the importance of psychological treatments in some patients
with constipation, rather than just relying on laxatives or enemas,''
Emmanuel said.
He noted that
he and his colleagues have found in other research that psychological
therapy improves both emotional health and bowel function in patients
with chronic constipation. Specifically, he said, a behavioral
therapy called biofeedback was shown to improve activity in nerve
pathways to the gut.
SOURCE:
Gut 2001;49:209-213.
Reference
Source 89
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