Mental Health

IBD may affect mental health by disrupting the gut-brain connection

IBD, or the inflammatory bowel disease, is the ongoing inflammation of all or part of the digestive tract, and it has two main types: Crohn’s disease and ulcerative colitis. While Crohn’s disease affects the gastrointestinal tract, such as the esophagus, stomach, and intestines, ulcerative colitis affects only the large intestine and rectum. Some symptoms of IBD include diarrhea, abdominal pain, weight loss, and fatigue while 30% of IBD patients also experience depression, anxiety, or both. Although many individuals with chronic illnesses have a greater risk of developing mental health issues due to the constant discomfort, it does not appear to be the sole cause for IBD patients.

The gut-brain axis is a hormonal, immunological, and neural connection between the central nervous system and the enteric nervous system, which controls the organs in the gastrointestinal system. Inflammation in the gut due to IBD may interfere with this axis, however, and impact the communication that accounts for the passage of molecules between blood and cerebrospinal fluid (CSF); this barrier, or the choroid plexus, shuts down once there are inflammatory signals from the gut so that, presumably, the inflammation does not spread to the brain. Research has found that shutting down the passage affects memory and is the leading cause of anxiety.

The choroid plexus is the barrier in the brain separating the blood from the CSF while producing the CSF. Co-senior author of the study, Dr. Maria Rescigno of Humanitas University and Humanitas Hospital, commented that “under healthy conditions, the choroid plexus connects the brain with the rest of the organism for both nutrient and metabolite exchange”. During intestinal inflammation, however, the choroid plexus closes down “in order to avoid inflammation further propagating to the brain…and this interaction with the rest of the organism is interrupted”. This isolation, as Dr. Rescigno, suggests that IBD leads to symptoms such as anxiety and poor memory.

Dr. Rescigno concludes the study that further research could lead to the development of treatments that restore the communication between the gut and the brain despite the inflammation, potentially resolving anxiety-like behaviors.


Categories: Mental Health