The impact of psychological stress and depression on functional gastrointestinal disorders in young people

Abstract

Background. Functional gastrointestinal disorders affect up to 25% of young people. Psychological stress and depression, through complex mechanisms, due to the close interdependence between the gastrointestinal tract, the hypothalamic-pituitary-adrenal axis and the brain, contribute to the exacerbation of symptoms. Objective(s). Analysis of the impact of psychological stress and depression in the pathophysiology of digestive symptoms in young people with irritable bowel syndrome (IBS) and functional dyspepsia (FD). Materials and methods. A systematic review of the scientific literature (29 sources) was conducted, examining the effect of psychological stress and depression on the onset and progression of functional gastrointestinal disorders, specifically IBS and functional dyspepsia, particularly in young individuals, utilizing the PubMed, Elsevier, and Springer databases. Results. Stress and depression have been identified as independent risk factors for FD and IBS in numerous studies, due to the mutual interaction between the brain and the intestines, through increased permeability, intestinal motility, epithelial dysfunction, immune activation, visceral hypersensitivity, dysbiosis modification; intestinal microbes can interact with stress hormones and produce a wide variety of neuroactive compounds. A higher stress score was confirmed in young men diagnosed with FD; depression was prevalent in young women with FD. The prevalence of IBS was estimated at 26,8%, of FD at 31,2% in young people. Conclusion(s). Psychological stress and depression were identified as key factors in the exacerbation of IBS and FD in young, through mechanisms mediated by the brain-gut axis. Multidisciplinary interventions, including psychotherapy (cognitive-behavioral therapy, relaxation methods) reduced symptoms by 40%.