D'Onofrio Antonio Maria, Di Vincenzo Federica, Ferrajoli Gaspare Filippo, Scaldaferri Franco, Camardese Giovanni
Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
UOS Malattie Infiammatorie Croniche Intestinali, CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
Case Rep Gastrointest Med. 2024 Mar 15;2024:3744500. doi: 10.1155/2024/3744500. eCollection 2024.
Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are lifelong conditions with no definite cure. Several studies demonstrated that patients with IBD more frequently experience symptoms of common mental disorders, such as anxiety and depression, because of bidirectional communication through the gut-brain axis and the chronicity of symptoms, as well as because of impaired quality of life and reduced social functioning. However, psychological conditions of affected patients are often underestimated and not fully considered. Herein, we present the case of a 37-year-old woman with Crohn's disease and a mild depressive condition, characterized by anxious distress, tachycardia, tachypnea, tremors, sweating, avoidant behaviors, and intestinal somatizations (diarrhea), who was treated with Pregabalin upon indication of the referring psychiatrist. Following the beginning of the treatment, the patient rapidly reported an improvement in the overall clinical symptoms as well as a better management of psychic and physical anxiety with a marked reduction in diarrheal discharges under stress at work. After 6 months of Pregabalin therapy, we additionally observed an improvement in Crohn's disease activity, both clinically, in the laboratory, and endoscopically. Our case showed that patients with Crohn's disease and anxiety problems may benefit from low-dose Pregabalin medication to improve both their mental and physical condition.
炎症性肠病(IBD),包括克罗恩病和溃疡性结肠炎,是无法彻底治愈的终身性疾病。多项研究表明,IBD患者更频繁地出现常见精神障碍症状,如焦虑和抑郁,这是由于通过肠-脑轴的双向交流、症状的慢性化,以及生活质量受损和社交功能减退。然而,受影响患者的心理状况往往被低估且未得到充分考虑。在此,我们报告一例37岁患有克罗恩病且伴有轻度抑郁状态的女性病例,其特征为焦虑不安、心动过速、呼吸急促、震颤、出汗、回避行为和肠道躯体化症状(腹泻),在转诊精神科医生的建议下接受了普瑞巴林治疗。治疗开始后,患者迅速报告整体临床症状有所改善,对精神和身体焦虑的控制更好,工作压力下腹泻次数明显减少。经过6个月的普瑞巴林治疗后,我们还观察到克罗恩病活动在临床、实验室和内镜检查方面均有所改善。我们的病例表明,患有克罗恩病且有焦虑问题的患者可能受益于低剂量普瑞巴林药物治疗,以改善其精神和身体状况。