Vashkevich Katsiaryna, Janiuk Kathryn, Maleki Nasim
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
Psychology Research Service, VA Healthcare System, Boston, MA, United States.
Front Med (Lausanne). 2023 May 24;10:1161130. doi: 10.3389/fmed.2023.1161130. eCollection 2023.
About 95% of human body serotonin synthesis occurs in the gastrointestinal tract (GI). Lack of sufficient serotonin levels is thought to play a key role in mood disorders, including anxiety disorders. In this study, we looked at a disorder affecting the GI tract, irritable bowel syndrome (IBS), and aimed to determine whether IBS is differentially associated with anxiety disorders in 252 chronic pain patients in the presence of a history of alcohol use disorders (AUD) given that alcohol is an extremely aggressive substance for the GI mucosa. We found that while the prevalence of IBS was not affected by the presence of AUD in chronic pain patients, IBS had significantly higher comorbidity with anxiety disorders in chronic pain patients with comorbid alcohol use disorders. We argue that these findings highlight mechanistic differences in the comorbidity of anxiety disorders with chronic pain and AUD, implicating a central role for GI problems stemming from chronic alcohol use. The findings may have important implications for the treatment of IBS patients with AUD who commonly present with anxiety disorders which could motivate the continuation of problematic drinking and impede recovery success. We propose that addressing GI problems in patients with AUD may help manage AUD and recovery more effectively.
人体约95%的血清素合成发生在胃肠道（GI）。血清素水平不足被认为在包括焦虑症在内的情绪障碍中起关键作用。在本研究中，我们观察了一种影响胃肠道的疾病——肠易激综合征（IBS），旨在确定在252名有酒精使用障碍（AUD）病史的慢性疼痛患者中，IBS与焦虑症的关联是否存在差异，因为酒精对胃肠道黏膜极具侵蚀性。我们发现，虽然慢性疼痛患者中IBS的患病率不受AUD的影响，但在合并酒精使用障碍的慢性疼痛患者中，IBS与焦虑症的共病率显著更高。我们认为，这些发现突出了焦虑症与慢性疼痛和AUD共病的机制差异，暗示了慢性酒精使用导致的胃肠道问题的核心作用。这些发现可能对患有AUD且常伴有焦虑症的IBS患者的治疗具有重要意义，焦虑症可能会促使问题饮酒持续存在并阻碍恢复成功。我们建议，解决AUD患者的胃肠道问题可能有助于更有效地管理AUD和促进康复。
