Over these past two weeks,
we have discussed how smoking is positively correlated with Chron’s Disease and
inversely correlated with Ulcerative Colitis. Although, the mechanism is still
unknown, many of us brought up the environmental factor stress. I know when I
was reading the articles; I thought that a possible explanation as to why
smoking can help people’s symptoms was just the fact that smoking may alleviate
stress in an individual.
When looking at the effects
of stress and the immune system in general, we know that stress causes the
release of cortisol, which is an immunodepressor. Additionally, immunodepressed
individuals are also more prone to inflammation. Furthermore, acute stress in
individuals causes a release of catecholamine’s, thus cortisol, and
inflammatory cytokines. All of these factors seem to link stress with IBD.
However, previous studies
have a hard time proving this. One reason is because of “recall bias”. There is
potential skew of data due to the fact that people falsely report, or don't
simply remember when the stress occurred and if it was associated with their
flare up. Another factor that was mentioned, that I didn’t think of, was that
stress is relative. One individual might think that an event in life is extremely
stressful while another individual might not interpret it the same way. Taking
these issues into consideration, past studies (also small) show a slight
correlation with stress and IBD.
Another interesting fact is
the role of neural influence and IBD. There was a case in which a man,
diagnosed with Ulcerative Colitis, had became paralyzed at the C5 level, and
had consequently went into complete remission. This further supports the idea
that the factors released from stress may be associated with IBD. With this
fact in mind, trials have been conducted using Lidocaine, a neuromodulator
drug, in treatment of Ulcerative Colitis, and have had some success.
As of now, there is no
concrete evidence to support this theory, so further studies must be performed.
However, most people recommend trying to keep stress levels down when diagnosed
with IBD to help prevent further flare-ups.
Feature,
Charlotte. "The Link Between Stress and Ulcerative Colitis." WebMD.
WebMD, 28 Sept. 2011. Web. 22 Oct. 2014.
"Inflammatory
Bowel Disease (IBD)." Lifestyle and Home Remedies. Mayo Clinic.
Web. 22 Oct. 2014.
Mawdsley, J.,
and D. Rampton. "Physiological Stress in IBD." National Center for
Biotechnology Information. U.S. National Library of Medicine, 26 Mar. 2005.
Web. 22 Oct. 2014.
Hello, Jenna. I think you made a good point suggesting that stress and IBD could be related in general. It seems to me that some people when they are under stress don’t pay attention to what they are eating or how much they eat. This could also play a role in flare ups, since over-eating or eating foods that are convenient but poor in nutrient content could also affect the digestive tract, the intestines included.
ReplyDeleteThats a good point to bring up about eating and stress, a lot of people "stress eat" which could definitely be related to their flare-ups. Personally I think that stress is indirectly related to IBD. Stress may be the reason that people do other sorts of things such as smoke, eat, and not be as healthy as they could be and thus promote IBD flare-ups.
ReplyDeleteI had the same thoughts about stress-eating and worsening the symptoms during a flare-up. I did some quick research myself, and I came across this paper on stress and IBD. It discusses a topic that I am familiar with from taking Health Psychology: psychoneuroimmunology. This is a growing field of psychological research in which the actions of the nervous system are observed for their possible impacts on immune function. It goes on to discuss the HPA (hypothalamic-pituitary-adrenal) axis of neurological function, and how its influence could be what is causing changes in the GI tract that manifest as the symptoms of IBD. It is an interesting paper and a fairly easy read!
ReplyDeletehttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774724/
I found interesting the point you brought up Jenna of stress being relative. While i know from my own experience how much stress can effect your body, i would imagine that overall there is some correlation between an individuals stress and flare ups in IBD. I would find a self report study among patients with IBD where a patient reports their levels of stress on a scale of 1-10 after a flare up and also rates the intensity of that flare up. I would be interested to see if there is a relationship here. To further look at this too a measure of cortisol could be measured as a more concrete measure of stress and this too compared to the measures mentioned above.
ReplyDeleteI really like your idea of measuring cortisol and then comparing this to the patients scale. This could help us "define" stress per individual and give more of a general base and comparisons between patients.
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