Psychological factors associated with inflammatory bowel disease.

BACKGROUND: Both depression and anxiety are identified as significant experiences in inflammatory bowel disease (IBD); whether these are a consequence of the disease or an active contributor to the disease remains controversial. This review aimed to identify and critique recent evidence regarding mental health in IBD. SOURCES OF DATA: PubmedⓇ, OvidⓇ, EmbaseⓇ, EBSCO PsychInfo and Google-Scholar were searched within the last 5 years (2016-2020). AREAS OF AGREEMENT: Overall, both depression and anxiety affect disease activity, relapse and healthcare utilization. AREAS OF CONTROVERSY: There is some controversy on whether depression and anxiety affect IBD outcomes differently depending on IBD subtype. GROWING POINTS: The data support the need for depression and anxiety assessment to be incorporated in the routine management of IBD patients; prompt psychiatric and psychological management may ultimately reduce disease activity, relapses and healthcare costs. AREAS TIMELY FOR DEVELOPING RESEARCH: More longitudinal research may further enlighten the role of depression and anxiety in IBD. Similarly, randomized controlled trials to investigate and clarify the effect of psychiatric/psychological management on IBD outcomes.

The prevalence of faecal incontinence in myotonic dystrophy type 1.

Faecal incontinence is recognised as a feature of myotonic dystrophy along with other symptoms of bowel dysfunction, but its prevalence is poorly defined. We have surveyed 152 unselected myotonic dystrophy patients. We identified issues with bowel control in 104 (68% of the study population). Forty-eight (32%) reported faecal incontinence in the 4 weeks prior to completion of the questionnaire. Fifty-six patients (37%) reported having to change their lifestyle because of incontinence issues at some point in the prior 4 weeks. This study shows a high frequency of life-changing symptoms in a large unselected, cohort of patients with myotonic dystrophy type 1, and highlights lower gastrointestinal symptoms as an important issue for further research.