The Connection Between IBS, Anxiety and Depression

Introduction: Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by three major symptoms : abdominal pain, diarrhea and constipation. A large number of studies suggest the importance of the brain - gut interaction in IBS. According to the latest researches, it was determined that IBS affects around 11% of the population globally, 50% to 90% of them report psychiatric disorders including depressive symptoms such as exhaustion, sleeping problems and loss of appetite, generalized anxiety disorder, social phobia, posttraumatic stress disorder, panic disorder and somatization disorder.Materials and Methods: We systematically searched online databases for randomly selected samples of general community populations. The current research outlines conclusions from data obtained from a wide-ranging and selected at random population sample that may elucidate these relations.Results: Studied data shows that IBS occurs in over 40% of individuals with panic disorder, and in patients with IBS, 25% to 30% have panic disorder, which has lead to speculation about potential common pathophysiology between the two. According to several studies, generalized anxiety disorder is more common in the early course of irritable bowel  syndrome, whereas depression is prevalent in patients with chronic IBS symptoms. On the contrary, psychiatric patients suffering from depression and generalized anxiety disorder have a significantly increased prevalence of IBS.Conclusion: The gathered information suggests that there are common neurobiological factors involving brain-gut interactions, depression and anxiety. The available data suggest diagnostic overlap between psychiatric disorders and irritable bowel syndrome, with similar demographic and clinical characteristics of the patients

A CASE REPORT OF A CHILD WITH SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS - A RARE BUT POTENTIALLY DANGEROUS DISEASE

Introduction:Juvenile idiopathic arthritis (JIA) is a heterogeneous group of conditions unified by the presence of chronic childhood arthritis without an identifiable cause. Systemic juvenile idiopathic arthritis (sJIA) is a rare form of this group characterised by systemic autoinflammation. It contributes to about two-thirds of the total mortality rate of JIA and is frequently complicated by macrophage activation syndrome. Clinical manifestations of the disease can be non-specific in the beginning and as a result the diagnosis can be delayed.Materials and Methods:We present a 13-year-old boy hospitalized at the St. Marina University Hospital, Varna with complaints of a fever over 38oC accompanied by a rash on the trunk. After physical examination, hyperemic throat, erythematous rash and cervical lymphadenopathy were discovered. The laboratory tests showed leukocytes - 19.32x109/L and CRP - 203.78 mg/l. Echocardiography and computed tomography revealed pericardial effusion and splenomegaly. The patient was diagnosed with acute pericarditis and treated with antibiotics but his condition was not improving. After a month he developed symptoms such as dyspnea, cough and joint pains and was admitted urgently to the Hospital. Further examinations were performed showing hemoglobin- 114 g/l, leukocytes - 23.37x109/L and pleural effusion in addition of the previous objective symptoms.Results: Due to the clinical presentation, the patient was diagnosed with sJIA. Now he is successfully treated with tocilizumab and methotrexate. Conclusion: The clinicians should be aware of sJIA as a disease with various clinical features in the beginning and the resemblance to infectious or malignant diseases. Early diagnosis and effective treatment are essential to achieve the best outcomes for the patients and to prevent fatal complications