Somatization in patients with predominant diarrhoea [IBS]: the role of the intestinal barrier function and integrity, 2021, Prospero et al

Andy

Andy

Retired committee member
Abstract

Background
Irritable bowel syndrome (IBS) is characterised by gastrointestinal (GI) and psychological symptoms (e.g., depression, anxiety, and somatization). Depression and anxiety, but not somatization, have already been associated with altered intestinal barrier function, increased LPS, and dysbiosis. The study aimed to investigate the possible link between somatization and intestinal barrier in IBS with diarrhoea (IBS-D) patients.

Methods
Forty-seven IBS-D patients were classified as having low somatization (LS = 19) or high somatization (HS = 28) according to the Symptom Checklist-90-Revised (SCL-90-R), (cut-off score = 63). The IBS Severity Scoring System (IBS-SSS) and the Gastrointestinal Symptom Rating Scale (GSRS) questionnaires were administered to evaluate GI symptoms. The intestinal barrier function was studied by the lactulose/mannitol absorption test, faecal and serum zonulin, serum intestinal fatty-acid binding protein, and diamine oxidase. Inflammation was assessed by assaying serum Interleukins (IL-6, IL-8, IL-10), and tumour necrosis factor-α. Dysbiosis was assessed by the urinary concentrations of indole and skatole and serum lipopolysaccharide (LPS). All data were analysed using a non-parametric test.

Results
The GI symptoms profiles were significantly more severe, both as a single symptom and as clusters of IBS-SSS and GSRS, in HS than LS patients. This finding was associated with impaired small intestinal permeability and increased faecal zonulin levels. Besides, HS patients showed significantly higher IL-8 and lowered IL-10 concentrations than LS patients. Lastly, circulating LPS levels and the urinary concentrations of indole were higher in HS than LS ones, suggesting a more pronounced imbalance of the small intestine in the former patients.

Conclusions
IBS is a multifactorial disorder needing complete clinical, psychological, and biochemical evaluations.

Open access, https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01820-7
 
Is this another case of correlation and causation being confused. It seems to suggest that somatising causes worse IBS. Surely people with worse IBS will be more aware of, worried by and seek help more for their physical symptoms.

I checked the definition of somatisation:
Somatisation is generally defined as the tendency to experience psychological distress in the form of somatic symptoms and to seek medical help for these symptoms, which may be initiated and/or perpetuated by emotional responses such as anxiety and depression.
Click to expand...
 
So if you ask people with more severe symptoms they will report more severe symptoms.

Wow thanks geniuses nobody would have thought of that. But sure just call more symptoms high somatization whatever it's just millions of lives who cares about this, really?

Seriously, health is too important to be left to physicians. This is simply not a functioning system, it has become a true parody of itself.
 
rvallee said:
So if you ask people with more severe symptoms they will report more severe symptoms.

Wow thanks geniuses nobody would have thought of that. But sure just call more symptoms high somatization whatever it's just millions of lives who cares about this, really?

Seriously, health is too important to be left to physicians. This is simply not a functioning system, it has become a true parody of itself.
Click to expand...

Yea well if you report s--t in technical terms then it looks impressive:
"Methods
Forty-seven IBS-D patients were classified as having low somatization (LS = 19) or high somatization (HS = 28) according to the Symptom Checklist-90-Revised (SCL-90-R), (cut-off score = 63).---"
How pray do you measure "somatization" OK --- see it now "Symptom Checklist-90-Revised" --- but hey they used the "revised" version --- so we can be assured!

OK the journal got paid to publish this and, yes I agree @rvallee , what's not to like --- if you're not one of those affected/family etc. Neat little fudge too --- bit's we can't explain, well that'll be the "somatization".
 
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