Antidepressants may be prescribed by GP as a new weapon in the war against irritable bowel syndrome

Antidepressants may soon be routinely prescribed by the GP to treat the most common bowel conditions in the UK.

Irritable bowel syndrome (IBS) affects 9 million British people and causes pain, bloating, diarrhea, and constipation, but there are few effective treatments.

Today, as part of a pioneering study of 75 healthcare hubs in northern and western England, hundreds of GPs offer patients low-dose mood-boosting drugs.

Researchers at the University of Leeds and the University of Bristol hope that if successful, prescribing antidepressants to IBS patients will become commonplace.

Irritable bowel syndrome (IBS) affects 9 million British people and causes pain, bloating, diarrhea, and constipation, but there are few effective treatments.

According to official guidance for doctors, antidepressants, usually used to treat mood disorders such as anxiety, depression, and obsessive-compulsive disorder, are used to treat symptoms if all other options fail. I can do it. Experts say this rarely happens because doctors are “too hesitant” to offer them.

“Some GPs may think they say they have depression or worry that all the symptoms are in their heads,” said a professor of gastroenterology at the University of Leeds. Collaborator Dr. Alex Ford said.

‘Others may not even know that they can use them. But there are hundreds of patients out there who are in desperate need of more options.

Dr. Ford hopes his research will give doctors the confidence to prescribe drugs early. “After this study, GP hopes to be confident in prescribing early, without having to first try other less effective diet treatments.”

Dr. Rehan Haidry, a gastroenterologist at University College Hospital in London, agrees. “I don’t think antidepressants are used very well to treat IBS,” he says.

“But I understand how often these drugs can change people’s lives. If GPs offer them often, they are much more convenient for both the healthcare system and the patient.

According to NHS data, this approach is arguably controversial amid growing concerns about the record number of British people already taking pills (1 in 6 adults).

In 2019, the National Institute for Health and Care Technology Health Watchdog issued the latest guidance warning of serious and long-term side effects associated with taking some antidepressants.

However, doctors believe that the benefits of this treatment outweigh the risks in some IBS patients.

Patients with IBS are usually given medication to control gastric muscle spasms, or laxatives if constipation is a problem. Some people work with nutritionists to adopt a diet that is low in fruits and vegetables that commonly cause symptoms. Only about half of patients benefit from these approaches.

For the past 20 years, researchers have investigated the relationship between gut health and mood. Research has shown that IBS symptoms worsen when patients experience stress and anxiety.

Last year, a major study by experts at the University of Southampton discovered a year of cognitive-behavioral therapy. This helped patients better manage their anxious thoughts and reduced IBS symptoms in 71% of patients, whereas regular treatment.

This treatment is currently recommended by the NHS for use when diets and medications have not proven to be effective. However, IBS antidepressants are not intended to reduce stress or anxiety in patients.

“The dose we give is about one-tenth the dose we give for mood problems,” said Professor Hazel Everitt, a Southampton general practitioner and primary care research expert, co-leading a new trial. doing. “We do not believe that it works by antidepressant effects.”

Instead, tricyclic antidepressants, a type of tricyclic antidepressant, are thought to act directly on the nerves of the intestine.

Compounds called neurotransmitters are found in the brain, are involved in mood regulation, and are also present in the nerves of the digestive system. And experts believe that antidepressants that act on the way these neurotransmitters work affect gastrointestinal discomfort.

Aoife Ryan, a 49-year-old marketing consultant from Wicklow, Ireland, has been taking 10 mg of amitriptyline for eight years after 20 years of nonstop debilitating bowel problems.

A recent analysis by British researchers found that tricyclic antidepressants relieve symptoms in about half of IBS patients compared to the third dose of placebopill.

According to Dr. Haidry, tricyclic antidepressants are ideal for a quarter of patients with intestinal hypersensitivity. Tricyclic antidepressants are also prescribed to treat migraine and other chronic pain conditions and work by blocking the pain signals that are delivered to the brain via nerves.

However, even in small doses, tricyclic antidepressants have no side effects.

Yes, please

Yoga Mad Deluxe Bag

Return to your yoga class in style with this lightweight cotton carrier. It’s seemingly spacious, with space for blocks, bricks, blankets, and mats.

£ 27.49, johnlewis.com

Yoga Mad Deluxe Bag

“They can cause drowsiness and dizziness,” says Dr. Hydley, who regularly prescribes amitriptyline to patients with both IBS and acid reflux disease. “Some people have very dry mouths, but the big advantage outweighs the low risk of a few small problems that usually disappear over time.

Aoife Ryan, a 49-year-old marketing consultant from Wicklow, Ireland, has been taking 10 mg of amitriptyline for eight years after 20 years of nonstop debilitating bowel problems.

She states: “If I don’t stop to use the toilet, it takes less than 10 minutes to get to work. I never leave home without Imodium and always know where the nearest toilet is when I’m out. Toilet.

Initially, her GP prescribed painkillers and advised her to take note of the trigger hood. However, if the problem persists, she was referred to a gastroenterologist and performed a scan to rule out inflammatory bowel disease.

She says:’When all the tests returned negative, the first thing he said was to try these antidepressants. I was surprised, but I would have had a candy bag if I thought it would be cured. “

Aoife suffered from “night terrors” for two weeks, but they disappeared, and in another two weeks her symptoms began to improve dramatically.

“I go to the bathroom non-stop, so I only go to the bathroom once or twice a day,” she says. “Previously, I was getting a 40-second warning before I had to go. Suddenly, the urgency stopped altogether.

“And I can’t remember when I last got a painkiller or a pill without bloating. The pill changed my life.

• For more information on the study or to volunteer to participate in the exam, please visit ctru.leeds.ac.uk / atlantis.