scholarly journals Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders

2005 ◽  
Vol 186 (6) ◽  
pp. 507-515 ◽  
Author(s):  
Francis Creed ◽  
Joy Ratcliffe ◽  
Lakshmi Fernandes ◽  
Stephen Palmer ◽  
Christine Rigby ◽  
...  

BackgroundIrritable bowel syndrome often leads to impaired functioning.AimsTo assess the contribution of psychiatric disorders to impaired outcome in severe irritable bowel syndrome.MethodPatients with severe irritable bowel syndrome entering a psychological treatment trial (n=257) were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. Outcomes were number of days of restricted activity, role limitation (physical) score of the Short Form Health Survey and costs.ResultsAt baseline, depressive disorder (29% of patients), panic (12%) and neurasthenia (35%) were associated with impairment; number of psychiatric disorders was associated in a dose–response fashion (P=0. 005). At follow-up, depressive disorder and neurasthenia were associated with role limitation score. Improved depression was associated with improved role functioning.ConclusionsDepressive, panic and neurasthenic disorders contribute to poor outcomes in severe irritable bowel syndrome, and appropriate treatment should be available to these patients.

2005 ◽  
Vol 39 (9) ◽  
pp. 807-815 ◽  
Author(s):  
Francis Creed ◽  
Elspeth Guthrie ◽  
Joy Ratcliffe ◽  
Lakshmi Fernandes ◽  
Christine Rigby ◽  
...  

Objective: We have previously reported improved health-related quality of life in patients with severe irritable bowel syndrome (IBS) following psychological treatments. In this paper, we examine whether this improvement was associated with improvement in psychological symptoms and was confined to those patients who had concurrent psychiatric disorder. Method: Two hundred and fifty-seven patients with severe IBS entering a psychological treatment trial were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry. At entry to the trial and 15 months later, patients were also assessed using the Hamilton Depression Rating Scale, Symptom Cheecklist-90 (SCL-90) and Short Form-36 (SF36) physical component summary score as the main outcome measure. Partial correlation was used to compare changes in SF36 score and changes in psychological scores while controlling for possible confounders, treatment group and baseline scores. Multiple regression analysis was used to examine whether changes in psychological scores, changes in pain and a history of abuse could account for most of the variance of change in SF36 physical component score. Results: Of 257 patients with severe IBS, 107 (42%) had a depressive, panic or generalized anxiety disorder at trial entry. There were moderate but significant correlations (0.21–0.47) between change in the psychological scores and the change in SF36 physical component scores. The correlation coefficients were similar in the groups with and without psychiatric disorder. The superiority of psychotherapy and antidepressant groups over treatment as usual was similar in those with and without psychiatric disorder. Multiple regression found significant independent effects of change in depression, anxiety, somatization and abdominal pain but there was still variance explained by treatment group. Conclusions: In severe IBS improvement in health-related quality of life following psychotherapy or antidepressants is correlated with, but not explained fully by reduction of psychological scores. A more complete understanding of how these treatments help patients with medically unexplained symptoms will enable us to refine them further.


Author(s):  
Akshaya Patil

Lifestyle disorders like unhealthy dietary habits, physical habits, disturbed sleep and rest patterns are the principal factors that cause many digestion related disease. Irritable bowel syndrome (IBS) is also one such disease which occurs due to the ingestion of unwholesome diet causing disturbances in Agni. According to Ayurvedic science, this disease can be considered as a Grahani roga. So we may consider IBS as Grahani roga. Various herbal medications and panchakarma (biopurification) procedures are described in the treatment of Grahani roga though there is no reliable medical treatment for IBS in modern medicine; various efforts have been made to overcome this problem by the virtue of Ayurvedic therapy. The present study was done to assess the efficacy of Panchmooladya choorna with Takra(buttermilk) as anupan in Group A(10Patients) and Group B(10Patients)with luke warm water as anupan in management of Grahani roga in total of 20patients.The results of therapy were assessed by various parameters after 1month with follow up of 15days.The result concluded that Panchmooladya choorna with Takra as anupan reduced the symptoms of Grahani rog as compared to Group B.


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