Colonoscopy: body and psyche. Can psychiatry contribute to the quality of the examination? / Yearbook 2023 / Issues / Current Problems of Psychiatry

Colonoscopy: body and psyche. Can psychiatry contribute to the quality of the examination?

Kolonoskopia: ciało i psychika. Czy psychiatria może przyczynić się do poprawy jakości badania?

REVIEW PAPER

Curr Probl Psychiatry 2023; 24, 253-268

10.12923/2353-8627/2023-0024

Adam Zaczek¹, Robert Pudlo²

¹ Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland

² Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland

Full Text

Abstract

Introduction: The relationship between a state of a body and mind is well known, although difficult to grasp. Its existence is reflected in subsequent editions of the classifications of mental disorders. One important and frequently performed medical procedure that significantly interferes with the patient's somatic state is colonoscopy. The aim of this study was to review the literature on the patient's psychological functioning in the context of colonoscopy.

Material and methods: A review of literature in PubMed and Scopus databases was conducted. Keywords used were: colonoscopy, psychiatry, mental disorders, psychogastroenterology, gut-brain axis, anxiety, depression, cognitive functions, pain perception, limiting the search scope to 2013-2023.

Discussion: The bidirectional relationship between psychological factors and a range of functional gastrointestinal disorders, contributed to the introduction of the term psychogastroenterology. One of its important areas is the research on the gut-brain axis. The interplay between the gut microbiome and mental functioning is apparent. Colonoscopy disrupts the composition of the intestinal microflora. However, despite its invasiveness, it is still often irreplaceable for the diagnosis and treatment of bowel diseases (including colorectal cancer). Higher adherence is needed, which could be achieved by improving patient comfort. An increased level of anxiety before the procedure and its negative impact on cognitive functioning is observed. Negative affect amplifies the experience of pain. Colonoscopy technique continues to be developed. A comprehensive description of the patient's psychological functioning in a colonoscopy situation is still lacking.

Conclusions: A comprehensive description of the patient's affective and cognitive determinants in the context of colonoscopy and the associated pain and discomfort would be advisable.

Keywords: psychiatry, gastroenterology, colonoscopy, gut-brain axis

Streszczenie

Wstęp: Związki między stanem ciała i samopoczuciem psychicznym są dobrze znane, choć trudne do uchwycenia. Ich istnienie znajduje odzwierciedlenie w kolejnych edycjach klasyfikacji zaburzeń psychicznych. Jedną z ważnych i często wykonywanych procedur medycznych, które istotnie ingerują w stan somatyczny pacjenta jest kolonoskopia. Celem niniejszej pracy był przegląd literatury dotyczącej funkcjonowania psychicznego pacjenta w kontekście kolonoskopii.

Materiał i metody: Analizie poddano artykuły z bazy PubMed i Scopus przy użyciu słów–kluczy: kolonoskopia, psychiatria, zaburzenia psychiczne, psychogastroenterologia, oś jelitowo-mózgowa, lęk, depresyjność, funkcje poznawcze, odczuwanie bólu, ograniczając zakres wyszukiwań do lat 2013-2023.

Dyskusja: Dwukierunkowe związki przyczynowo-skutkowe między czynnikami psychologicznymi i szeregiem czynnościowych zaburzeń przewodu pokarmowego, przyczyniły się do wprowadzenia pojęcia psychogastroenterologii. Jednym z jej ważnych obszarów jest badanie osi jelitowo-mózgowej. Wzajemny wpływ mikrobiomu jelitowego i funkcjonowania psychicznego jest widoczny m.in. w reakcjach organizmu na stres, chorobach przebiegających z otępieniem, schizofrenii, zaburzeniach depresyjnych, chorobie afektywnej dwubiegunowej czy zaburzeniach neurorozwojowych. Kolonoskopia zaburza skład mikroflory jelitowej. Mimo swojej inwazyjności nadal bywa niezastąpiona w zakresie diagnozowania i leczenia chorób jelit (m.in. raka jelita grubego). Potrzebna jest poprawa zgłaszalności, na co mogłoby wpłynąć zwiększenie komfortu pacjentów. Obserwowane jest nasilenie lęku przed procedurą oraz jej negatywny wpływ na funkcjonowanie poznawcze. Negatywny afekt wzmaga odczuwanie bólu. Technika badania kolonoskopowego wciąż jest rozwijana. Nadal brakuje przekrojowego opisu funkcjonowania psychicznego pacjenta w sytuacji kolonoskopii.

Wnioski: Wskazane jest kompleksowe badanie związków bólu i dyskomfortu z afektem i funkcjami poznawczymi pacjenta w kontekście badania kolonoskopowego.

Słowa kluczowe: psychiatria, gastroenterologia, kolonoskopia, oś jelitowo-mózgowa

Pliki do pobrania

cpp-2023-0024.pdf

References

Kępiński A. Lęk. Warszawa: PZWL; 1977, s.42.
Basavarajappa C, Dahale AB, Desai G. Evolution of bodily distress disorders. Curr Opin Psychiatry. 2020;33(5):447–450.
Löwe B, Levenson J, Depping M, Hüsing P, Kohlmann S, Lehmann M, et al. Somatic symptom disorder: a scoping review on the empirical evidence of a new diagnosis. Psychol Med. 2022 Mar;52(4):632-648.
Gomez-Bernal F, Madva EN, Puckett J, Amonoo HL, Millstein RA, Huffman JC. Relationships between life stressors, health behaviors, and chronic medical conditions in mid-life adults: a narrative review. Psychosomatics. 2019;60(2):153–63.
International Classification of Diseases, Eleventh Revision (ICD11), World Health Organization (WHO) 2019/2021.
Cao J, Ding L. Psychosomatic practice in gastroenterology: new insights and models from China. Psychother Psychosom 2019;88(6):321–326.
Koloski N, Holtmann G, Talley N. Is there a causal link between psychological disorders and functional gastrointestinal disorders? Expert Rev Gastroenterol Hepatol. 2020;14(11):1047– 1059.
Keefer L, Palsson OS, Pandolfino JE. Best practice update: incorporating psychogastroenterology into management of digestive disorders. Gastroenterology. 2018;154(5):1249–1257.
Helander HF, Fandriks L. Surface area of the digestive tract– revisited. Scand J. Gastroenterol. 2014;49(6):681–689.
Sender R, Fuchs S, Milo R. Revised estimates for the number of human and bacteria cells in the body. PLoS Biol. 2016;14(8):e1002533.
Senchukova MA. Microbiota of the gastrointestinal tract: Friend or foe? World J Gastroenterol. 2023;29(1):19-42.
Rinninella E, Raoul P, Cintoni M, Franceschi F, Miggiano GAD, Gasbarrini A, et al. What is the healthy gut microbiota composition? A changing ecosystem across age, environment, diet, and diseases. Microorganisms. 2019;7(1):14.
Pascale A, Marchesi N, Marelli C, Coppola A, Luzi L, Govoni S, et al. Microbiota and metabolic diseases. Endocrine 2018;61(3):357-371.
Bonaz B, Bazin T, Pellissier S. The vagus nerve at the interface of the microbiota-gut-brain axis. Front Neurosci. 2018;12:49.
Shaik L, Kashyap R, Thotamgari SR, Singh R, Khanna S. Gutbrain axis and its neuro-psychiatric effects: a narrative review. Cureus. 2020;12(10):e11131.
Cuesta CM, Guerri C, Ureña J, Pascual M. Role of microbiota-derived extracellular vesicles in gut-brain communication. Int J Mol Sci. 2021;22(8):4235.
van de Wouw M, Lyte JM, Boehme M, Sichetti M, Moloney G, Goodson MS, et al. The role of the microbiota in acute stressinduced myeloid immune cell trafficking. Brain, Behavior, and Immunity. 2020;84:209-217.
Naveed M, Zhou QG, Xu C, Taleb A, Meng F, Ahmed B, et al. Gutbrain axis: a matter of concern in neuropsychiatric disorders…! Prog NeuroPsychopharmacol Biol Psychiatry. 2021;104:110051.
Simpson CA, Diaz-Arteche C, Eliby D, Schwartz OS, Simmons JG, Cowan CSM. The gut microbiota in anxiety and depression – a systematic review. Clin Psychol Rev. 2021;83:101943.
Maiuolo J, Gliozzi M, Musolino V, Carresi C, Scarano F, Nucera S, et al. The contribution of gut microbiota–brain axis in the development of brain disorders. Front Neurosci. 2021;15:616883.
Socała K, Doboszewska U, Szopa A, Serefko A, Włodarczyk M, Zielińska A, et al. The role of microbiota-gut-brain axis in neuropsychiatric and neurological disorders. Pharmacol Res. 2021;172:105840.
Margolis KG, Cryan JF, Mayer EA. The microbiota-gut-brain axis: From motility to mood. Gastroenterology. 2021;160(5):1486- 1501.
Sanada K, Nakajima S, Kurokawa S, Barcelo-Soler A, Ikuse D, Hirata A, et al. Gut microbiota and major depressive disorder: a systematic review and meta-analysis. J Affect Disord. 2020;266:1-13.
Borkent J, Ioannou M, Laman JD, Haarman BC, Sommer IE. Role of the gut microbiome in three major psychiatric disorders. Psychol Med. 2022;52(7):1222-1242.
Valles-Colomer M, Falony G, Darzi, Y, Tigchelaar EF, Wang J, Tito RY, et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nat Microbiol. 2019;4(4):623- 632.
Marx W, McGuinness AJ, Rocks T, Ruusunen A, Cleminson J, Walker AJ, et al. The kynurenine pathway in major depressive disorder, bipolar disorder, and schizophrenia: a meta-analysis of 101 studies. Mol. Psychiatry. 2021;26(8):4158-4178
Morris G, Berk M, Carvalho A, Caso JR, Sanz Y, Walder K, et al. The role of the microbial metabolites including tryptophan catabolites and short chain fatty acids in the pathophysiology of immune-inflammatory and neuroimmune disease. Mol Neurobiol. 2016;54(6):4432-4451 .
Hoban AE, Stilling RM, Ryan FJ, Shanahan F, Dinan TG, Claesson MJ, et al. Regulation of prefrontal cortex myelination by the microbiota. Transl Psychiatry. 2016;6(4):e774.
Nguyen TT, Kosciolek T, Eyler LT, Knight R, Jeste DV. Overview and systematic review of studies of microbiome in schizophrenia and bipolar disorder. J Psychiatr Res. 2018;99:50–61.
Yang JC, Troutman R, Buri H, Gutta A, Situ J, Aja E, et al. Ileal Dysbiosis Is Associated with Increased Acoustic Startle in the 22q11.2 Microdeletion Mouse Model of Schizophrenia. Nutrients. 2023;15(16):3631.
Zhu F, Guo R, Wang W, Ju Y, Wang Q, Ma Q, et al. Transplantation of microbiota from drug-free patients with schizophrenia causes schizophrenia-like abnormal behaviors and dysregulated kynurenine metabolism in mice. Mol Psychiatry. 2019;25(11):2905-2918.
Zheng P, Zeng B, Liu M, Chen J, Pan J, Han Y, et al. The gut microbiome from patients with schizophrenia modulates the glutamate-glutamine-GABA cycle and schizophrenia-relevant behaviors in mice. Sci Adv. 2019;5(2):eaau8317.
Uno Y, Coyle JT. Glutamate hypothesis in schizophrenia. Psychiatry Clin Neurosci. 2019;73(5):204-215.
Khandaker GM, Cousins L, Deakin J, Lennox BR, Yolken R, Jones PB. Inflammation and immunity in schizophrenia: implications for pathophysiology and treatment. Lancet Psychiatry. 2015;2(3):258-270.
Fond G, Lançon C, Korchia T, Auquier P, Boyer L. The role of inflammation in the treatment of schizophrenia. Front. Psychiatry. 2020;11:160.
Karakuła-Juchnowicz H, Dzikowski M, Pelczarska A, Dzikowska I, Juchnowicz D. The brain-gut axis dysfunctions and hypersensitivity to food antigens in the etiopathogenesis of schizophrenia. Psychiatr Pol. 2016;50(4):747-760.
Nemani K, Hosseini Ghomi R, McCormick B, Fan X. Schizophrenia and the gut-brain axis. Prog Neuropsychopharmacology Biol Psychiatry. 2015;56:155–160.
Schwarz E, Maukonen J, Hyytiäinen T, Kieseppä T, Orešiè M, Sabunciyan S, et al. Analysis of microbiota in first episode psychosis identifies preliminary associations with symptom severity and treatment response. Schizophr Res. 2018;192:398–403.
Bartoli F, Misiak B, Callovini T, Cavaleri D, Cioni RM, Crocamo C, et al. The kynurenine pathway in bipolar disorder: a metaanalysis on the peripheral blood levels of tryptophan and related metabolites. Mol Psychiatry. 2021;26(7):3419-3429.
Puricelli C, Rolla R, Gigliotti L, Boggio E, Beltrami E, Dianzani U, et al. The gut-brain-immune axis in autism spectrum disorders: a state-of-art report. Front Psychiatry. 2022;12:755171.
Jang SH, Woo YS, Lee SY, Bahk WM. The brain-gut-microbiome axis in psychiatry. Int J Mol Sci. 2020;21(19):7122.
Rog A, Skonieczna-Żydecka K, Juchnowicz D, Padała O, Łoniewski I, Budzyńska B, et al. Gut microbiota and intestinal barrierrelated markers in patients with anorexia nervosa: systematic review. Psychiatr Pol. 2022;1-20.
Karakuła-Juchnowicz H, Pankowicz H, Juchnowicz D, Valverde Piedra JL, Małecka-Massalska T. Intestinal microbiota – a key to understanding the pathophysiology of anorexia nervosa? Psychiatr Pol. 2017;51(5):859-870.
Wang Z, Wang Z, Lu T, Chen W, Yan W, Yuan K, et al. The microbiota-gut-brain axis in sleep disorders. Sleep Med Rev. 2022;65:101691.
Wang SC, Chen YC, Chen SJ, Lee CH, Cheng CM. Alcohol addiction, gut microbiota, and alcoholism treatment: a review. Int J Mol Sci. 2020;21(17):6413.
Bastiaanssen TFS, Cowan CSM, Claesson MJ, Dinan TG, Cryan JF. Making Sense of … the Microbiome in Psychiatry. Int J Neuropsychopharmacol. 2019;22(1):37-52.
Stopińska K, Radziwoń-Zaleska M, Domitrz I. The microbiotagut-brain axis as a key to neuropsychiatric disorders: a mini review. J Clin Med. 2021;10(20):4640.
Li S, Hua D, Wang Q, Yang L, Wang X, Luo A, et al. The role of bacteria and its derived metabolites in chronic pain and depression: recent findings and research progress. Int J Neuropsychopharmacol. 2020;23(1):26–41.
Vancamelbeke M, Vermeire S. The Intestinal Barrier: A Fundamental Role in Health and Disease. Expert Rev Gastroenterol Hepatol. 2017;11(9):821-834.
Staudacher HM, Mikocka-Walus A, Ford AC. Common mental disorders in irritable bowel syndrome: pathophysiology, management, and considerations for future randomised controlled trials. Lancet Gastroenterol Hepatol. 2021;6(5):401- 410.
Suganya K, Koo B-S. Gut-brain axis: role of gut microbiota on neurological disorders and how probiotics/prebiotics beneficially modulate microbial and immune pathways to improve brain functions. Int. J. Mol. Sci. 2020;21(20):7551.
Goh KK, Liu Y-W, Kuo P.-H., Chung Y-CE, Lu M-L, Chen C-H. Effect of probiotics on depressive symptoms: a meta-analysis of human studies. Psychiatry Res. 2019;282:112568.
Drago L, Casini V, Pace F. Gut microbiota, dysbiosis and colon lavage. Dig Liver Dis. 2019;51(9):1209-1213.
Meroni G, Pace F, Grossi E, Casini V, Drago L. Bacterial network community in fecal and endoluminal Microbiota after colonoscopy. New Microbiol. 2020;43(1):22–27
Kim JH, Choi YJ, Kwon HJ, Jung K, Kim SE, Moon W, et al. Effect of gut microbiome on minor complications after a colonoscopy. Intest Res. 2021;19(3):341–348.
Di Leo M, Iannone A, Arena M, Losurdo G, Palamara MA, Iabichino G, et al. Novel frontiers of agents for bowel cleansing for colonoscopy. World J Gastroenterol. 2021;27(45):7748–7770.
Nagata N, Tohya M, Fukuda S, Suda W, Nishijima S, Takeuchi F, et al. Effects of bowel preparation on the human gut microbiome and metabolome. Sci Rep. 2019;9(1):4042.
Palleja A, Mikkelsen KH, Forslund SK, Kashani A, Allin KH, Nielsen T, et al. Recovery of gut microbiota of healthy adults following antibiotic exposure. Nat Microbiol. 2018;3(11):1255– 1265.
Kaminski MF, Robertson DJ, Senore C, Rex DK. Optimizing the quality of colorectal cancer screening worldwide. Gastroenterology. 2020;158(2):404–17.
Wu W, Huang J, Yang Y, Gu K, Luu HN, Tan S, et al. Adherence to colonoscopy in cascade screening of colorectal cancer: a systematic review and meta-analysis. J Gastroenterol Hepatol. 2022;37(4):620–631
Saito Y, Oka S, Kawamura T, Shimoda R, Sekiguchi M, Tamai N, et al. Colonoscopy screening and surveillance guidelines. Dig Endosc. 2021;33(4):486–519.
Chandan S, Facciorusso A, Yarra P, Khan SR, Ramai D, Mohan BP, et al. Colonoscopy related adverse events in patients with abnormal stool-based tests: a systematic review of literature and meta-analysis of outcomes. Am J Gastroenterol 2022;117(3):381–393.
Kanth P, Inadomi JM. Screening and prevention of colorectal cancer. BMJ. 2021;374:n1855.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249.
Li P, He X, Yang X, Du J, Wu W, Tu J. Patient education by smartphones for bowel preparation before colonoscopy. Gastrology and Hepatology. 2022;37(7):1349-1359.
Yang C, Sriranjan V, Abou-Setta AM, Poluha W, Walker JR, Singh, H. Anxiety associated with colonoscopy and flexible sigmoidoscopy: a systematic review. The American Journal of Gastroenterology. 2018;113(12):1810-1818.
Shafer LA, Walker JR, Waldman C, Yang C, Michaud V, Bernstein CN, et al. Factors associated with anxiety about colonoscopy: the preparation, the procedure, and the anticipated findings. Dig Dis Sci. 2018;63(3):610–8.
Park J, Moghaddam B. Impact of anxiety on prefrontal cortex encoding of cognitive flexibility. Neuroscience. 2017;345:193– 202.
Ackland GL, Harrington J, Downie P, Holding JW, Singh-Ranger D, Griva K,et al. Dehydration induced by bowel preparation in older adults does not result in cognitive dysfunction. Anesth Analg. 2008;106(3):924–929.
Wadsworth P, Blackburne H, Dixon L, Dobbs B, Eglinton T, Ing A. Does Bowel Preparation for Colonoscopy Affect Cognitive Function? Medicine (Baltimore). 2015;94(44):e1823.
Reumkens A, van der Zander Q, Winkens B, Bogie R, Bakker CM, Sanduleanu S, et al. Electrolyte disturbances after bowel preparation for colonoscopy: systematic review and metaanalysis. Dig Endosc. 2022;34(5):913–926.
Hsueh F-C, Chen C-M, Sun C-A, Chou Y-C, Hsiao S-M, Yang T. A Study on the effects of a health education intervention on anxiety and pain during colonoscopy procedures. J Nurs Res. 2016;24(2):181-9.
Xiao X, Zhang YQ. A new perspective on the anterior cingulate cortex and affective pain. Neurosci Biobehav Rev. 2018;90:200- 211.
Fu L, Dai M, Liu J, Shi H, Pan J, Lan Y, et al. Study on the influence of assistant experience on the quality of colonoscopy: a pilot single-center study. Medicine (Baltimore), 2019;98(45):e17747.
Sapci I, Jia X, Wu J, Gorgun E, Liska D, Church J, et al. Does time of day matter for colonoscopy quality? A review of over 13,000 screening colonoscopies in a colorectal surgery unit. Am J Surg. 2022;223(3):500-502.
Ramai D, Singh J, Brooks OW, Barakat M, Mohan BP, Chandan S, et al. Comparison of left versus right lateral starting position on colonoscopy: a systematic review and metaanalysis of randomized controlled trials. Ann Gastroenterol. 2021;34(5):699-704.
Sorkpor SK, Johnson CM, Santa Maria DM, Miao H, Moore C, Ahn H. The effect of music listening on pain in adults undergoing colonoscopy: a systematic review and meta-analysis. J Perianesth Nurs. 2021;36(5):573-580.e1
Shine R, Bui A, Burgess A. Quality indicators in colonoscopy: an evolving paradigm. ANZ J Surg. 2020;90(3):215–221.
Seward E. Recent advances in colonoscopy. F1000Res. 2019;8:F1000 Faculty Rev-1028.
Joseph J, LePage EM, Cheney CP, Pawa R. Artificial intelligence in colonoscopy. World J Gastroenterol. 2021;27(29):4802-4817.
Khan R, Zheng E, Wani SB, Scaffidi MA, Jeyalingam T, Gimpaya N, et al. Colonoscopy competence assessment tools: a systematic review of validity evidence. Endoscopy. 2021;53(12):1235–1245.
Rosvall A, Gershater MA, Kumlien C, Toth E. Patient-reported experience measures for colonoscopy: a systematic review and meta-ethnography.

Calendar

Październik 2024

Wszystkie

Pon	Wto	Śro	Czw	Pią	Sob	Nie
	01	02	03	04	05	06
07	08	09	10	11	12	13
14	15	16	17	18	19	20
21	22	23	24	25	26	27
28	29	30	31