Inflammatory bowel disease and anxiety: Links, risks, and challenges faced

Abstract

Inflammatory bowel disease (IBD) comprises two major gastrointestinal disorders namely Crohn’s disease (CD) and ulcerative colitis (UC). It has a profound impact on a patient’s life. IBD can affect people of all ages, but is most often diagnosed at a young age. It has a chronic nature and follows an unpredictable course with flares and remissions. Approximately 25%–50% of patients relapse annually. The etiology of IBD is not well recognized. It is now understood that it may relate to the complex interaction between genetic and environmental factors in vulnerable individuals. This interaction results in an inappropriate and exaggerated intestinal inflammatory response.1–3 IBD is a common condition. In the UK, CD affects around one in every 650 people, while UC affects around one in every 420 people.4 The incidence of CD in Europe ranges from 0.5–10.6 cases per 100,000 person-years, while the estimates for UC range from 0.9–24.3 per 100,000 person-years.5 There are great variations between countries, with generally higher inci¬dences in more northern countries, and an increasing incidence has been noted in devel¬oping countries. Psychological effects from IBD and IBD medications are experienced by many patients with IBD. Anxiety, especially, can have a profound effect on quality of life, including the ability to work and have a family life. This paper reviews the current evidence to help clinicians looking after patients with IBD who experience anxiety.