Antidepressants could ease pain for sufferers of inflammatory bowel disease

Antidepressants may have a greater role than previously thought in alleviating the symptoms of inflammatory bowel disease (IBD), an incurable and debilitating condition affecting 85,000 Australians.

Deakin University Associate Professor of Psychology Antonina Mikocka-Walus says more needed to be known about prescribing antidepressants for IBD, including for those who do not have anxiety or depression.

While between 10 per cent and 30 per cent of people with IBD use antidepressants in Western countries it is unclear how many take them specifically for IBD symptoms or for mental illness.

In her paper, ‘Antidepressants in inflammatory bowel disease’ recently published in Nature Reviews Gastroenterology & Hepatology, Associate Professor Mikocka-Walus calls for more research into the impact of antidepressants on alleviating the physical symptoms of IBD, including pain and inflammation.

Associate Professor Mikocka-Walus has examined research papers from Australia and overseas in finding solutions to treating IBD – a chronic, inflammatory disease affecting the gastrointestinal tract, predominantly in conditions of Crohn’s disease and ulcerative colitis. There is no cure and Australia has one of the highest rates of prevalence in the world.

In some patients, the gut becomes hypersensitive even in the periods of remission, when there is no or little inflammation in their bowel, diarrhoea and pain remain a daily occurrence.

“We are finding there may be more scope for using antidepressants to ease the pain and inflammation of IBD and other illnesses,” she said.

In related research published in two sister papers in the Internal Medicine Journal and JGH Open earlier this year, Associate Professor Mikocka-Walus surveyed 731 Australians with IBD and found about half of them had experienced mental distress but did not have access to psychological support alongside their regular treatment.

“What we know is that when a person suffers from IBD they are at a greater risk of developing anxiety or depression; having a poorer quality of life than the general population; and tragically, of taking their own lives,” she said.

“IBD is associated with a nearly six-fold risk for anxiety and is negatively affected by mental illness, resulting in more frequent flare ups, a more aggressive presentation, hospital readmission and increased risk of surgery.

“All compelling reasons why research into the role of antidepressants and further studies of psychotherapy in treating the symptoms of this disease are so vital.”

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