LETTER

Further evidence supporting a psychological component to irritable bowel syndrome

M Castle¹, G W Libby¹

¹ Departments of Gastroenterology and Psychiatry, Barts and the London National Health Services Trust and the Wingate Institute of Neurogastroenterology, London, UK

Correspondence to:
Correspondence to:
Dr G W Libby
Departments of Gastroenterology and Psychiatry, Barts and the London National Health Services Trust and the Wingate Institute of Neurogastroenterology, 9 Upper Wimpole Street, London W1G 6LJ, UK; Gerald.libby@btconnect.com

The first 150 words of the full text of this article appear below.

We welcome the conclusion by Creed (Gut 2006;55:1065–7) that citalopram leads to clinical improvement in irritable bowel syndrome (IBS) uncomplicated by psychiatric illness¹ by targeting psychological processes. The implicit assumption is that psychological disturbance is fundamental to IBS, irrespective of psychiatric comorbidity.

This is consistent with a previously proposed disease model for functional gastrointestinal disorders,² which suggested that dominant, shared psychological disturbance provides the best explanation for the very high overlap between IBS, other functional disorders (gastrointestinal and otherwise) and depression/anxiety. The model also explained how depression and IBS can wax and wane independently, and predicted that the response of non-psychiatric IBS to selective serotonin reuptake inhibitor antidepressants would be similar to the response of depressive disorders to selective serotonin reuptake inhibitors.

We also welcome the author’s identification of abnormal illness beliefs as the principal psychological pathology. Evidence suggesting that these beliefs are causative in IBS³ . . . [Full text of this article]

Lukas Van Oudenhove^2,*, Jan Tack²

² Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Belgium

Correspondence to:
Correspondence to:
Dr J Tack
Department of Pathophysiology, Gastroenterology Section—Center for Gastroenterological Research, University Hospital Gasthuisberg–University of Leuven, Herestraat 49, Leuven B-3000, Belgium; jan.tack@med.kuleuven.be

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