47. Does Stress Matter?

  1. Peter M. Irving MD, MRCP3,
  2. Corey A. Siegel MD, MS4,5,6,
  3. David S. Rampton DPhil, FRCP7 and
  4. Fergus Shanahan MD8,9
  1. Robert G. Maunder MD1,2

Published Online: 30 JAN 2012

DOI: 10.1002/9781444342574.ch47

Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges, Second Edition

Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges, Second Edition

How to Cite

Maunder, R. G. (2011) Does Stress Matter?, in Clinical Dilemmas in Inflammatory Bowel Disease: New Challenges, Second Edition (eds P. M. Irving, C. A. Siegel, D. S. Rampton and F. Shanahan), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444342574.ch47

Editor Information

  1. 3

    Department of Gastroenterology, Guy's and St Thomas' Hospitals, London, UK

  2. 4

    The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA

  3. 5

    Dartmouth Medical School, Lebanon, NH, USA

  4. 6

    Inflammatory Bowel Disease Center, Dartmouth–Hitchcock Medical Center, Section of Gastroenterology and Hepatology, Lebanon, NH, USA

  5. 7

    Centre for Digestive Diseases, Barts and The London School of Medicine and Dentistry, London, UK

  6. 8

    Department of Medicine, Cork, Ireland

  7. 9

    Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland

Author Information

  1. 1

    Mount Sinai Hospital, Toronto, ON, Canada

  2. 2

    University of Toronto, Toronto, ON, Canada

Publication History

  1. Published Online: 30 JAN 2012
  2. Published Print: 1 OCT 2011

ISBN Information

Print ISBN: 9781444334548

Online ISBN: 9781444342574

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Keywords:

  • Crohn's disease;
  • ulcerative colitis;
  • psychological stress;
  • depression;
  • anxiety

Summary

Several plausible mechanisms explain how stress may increase gut inflammation. There is good evidence that stress contributes to relapse in ulcerative colitis (UC) and that depressive symptoms contribute to inflammation in Crohn's disease (CD). However, the effect size is not consistently large, and it is likely that psychological factors only contribute to disease course in a subset of patients. Stress, depressive symptoms, and anxiety also increase the burden and cost of having IBD. Furthermore, psychological factors influence symptom reporting and make assessment of IBD disease severity more complex. Fortunately, there are promising new developments to treat psychological distress in IBD patients.