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Anxiety and depression: a common feature of health care seeking patients with irritable bowel syndrome and food allergy.

BACKGROUND/AIMS
Irritable bowel syndrome (IBS) is a chronic disorder of the gastrointestinal tract. The etiology of IBS is still unclear and the relationship between foods and IBS is controversial; psychological factors have always been considered as a major cause of IBS and we recently showed a possible association via anxiety and depression between IBS and food allergy (FA). The aim of the present study was to confirm our preliminary observation.


METHODOLOGY
Sixty-high IBS, 44 FA, 48 non-healthy controls with lactose intolerance (LI) and 52 healthy controls were considered for the study. All the subjects were given the State and Trait Anxiety Inventory and the Zung depression scale.


RESULTS
The percentage of subjects with high levels of state anxiety, trait anxiety and depression was significantly higher in IBS than in both LI and healthy controls; psychological findings in patients with FA were very similar to those of IBS. There were higher levels of state anxiety in LI compared to healthy controls.


CONCLUSIONS
A higher prevalence of state anxiety found in patients complaining of bowel symptoms could be linked to the presence of chronic ill status. The higher presence of trait anxiety and depression in IBS and FA patients could be responsible for an increase in the activity of the autonomic nervous system and could provoke motility alterations through mast cell mediator release as well as enhancing release due to allergen crosslinking with IgE at the mast cell surface. However, it is debatable whether psychological findings are characteristic of all IBS or FA patients, or just represent the subset that see physicians.