Antidepressants for IBS?

One of the most common gastrointestinal disorders is irritable bowel syndrome, which causes recurrent cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is related to abnormal motility (too fast causing diarrhea or too slow causing constipation), visceral hypersensitivity which is increased sensitivity in the nerves in the GI tract which leads to discomfort and cramping. Lastly, it also shows poor brain-gut function where the brain is overly responsive to the pain signals coming from the GI tract and is worsened when an individual is experiencing stress. Antidepressants like SSRIs (selective serotonin reuptake inhibitors) and SNRIs (Serotonin-Norepinephrine reuptake inhibitors) have been shown to help with the brain and spinal cord function properly and help reduce visceral hypersensitivity. 

What is not talked about though is that there is a lot of strain on the people who have IBS, not feeling well all the time can make it difficult to not be worried and stressed. Being worried and stressed worsens the symptoms and creates a very difficult cycle for someone to be stuck in. These drugs can help reduce depression and anxiety symptoms and help people feel better. 

 

I wanted to talk about this since I learned that SNRI’s have a been effective in reducing the symptoms of IBS which was interesting, and I wanted to know what the physiology was behind it. I think IBS is an illness that is complex and can be caused by multiple different things, and it seems like every person with IBS has different experiences. I do find it very interesting to see stress has a big role on digestion and a decrease in norepinephrine can lead to improvement in symptoms, which I think shows how dependent all of the different systems in the body are on each other and sometimes the solution to one system starts somewhere else. 

In terms of how this can relate to ethics in science, I think it can show how experimental design can be altered to broaden how we think and measure the human body, for example recently more research is being done on how the microbiome effects the immune system, mental illness, and even likelihood of developing cancer. It is very interesting, and many people may assume that the bacteria in our intestines have very little to do with mental health, but according to new studies that is not true. I think experimental designs in physiology is moving towards being more wholestic when it comes to looking at small part of the body or dieases which I think will lead to more effective and unique research. 

Citation: https://www.med.unc.edu/ibs/wp-content/uploads/sites/450/2017/10/IBS-and-Antidepressants.pdf