# Mast cell and cellularity of the colonic mucosa correlated with fatigue and depression in the irritable bowel syndrome.



## eric (Jul 8, 1999)

Mast cell and cellularity of the colonic mucosa correlated with fatigue and depression in the irritable bowel syndrome. Gut. 2008 Jan 14 [Epub ahead of print]Mast cell and cellularity of the colonic mucosa correlated with fatigue and depression in the irritable bowel syndrome.Piche T, Saint Paul MC, Dainese R, Marine-Barjoan E, Iannelli A, Montoya ML, Peyron JF, Czerucka D, Cherikh F, Filippi J, Tran A, Hébuterne X.France.BACKGROUND: A subset of patients with the irritable bowel syndrome (IBS) has an increased number of mast cells (MCs) in the colonic mucosa. Psychological factors are believed to contribute to the course of IBS. AIMS: To examine associations between fatigue, depression and MCs of the colonic mucosa in IBS. METHODS: Colonic biopsies were taken from 50 Rome II IBS patients, 21 healthy controls and 11 depressed/fatigued patients without IBS. The cellularity of the lamina propria referred as the number of inflammatory cells per high power field (hpf) through a 400x microscope. The Fatigue Impact Scale (FIS) and the short form Beck Depression Inventory (BDI) evaluated the severity of fatigue and depression. RESULTS: IBS had a significant increase of the cellularity of the lamina propria compared to controls or to depressed patients (94.5[48-110] vs 68[58-82] and 78[87-90] cells per hpf, p=0.005 and p=0.05 respectively), in particular of MCs (9.3[5.6-11.7] vs 4.0[2.7-6.8] and 4.3[2.8-7.8] cells per hpf, p=0.001 and p=0.005 respectively). Both FIS and BDI scores were significantly higher in IBS than in controls or in depressed patients (p<0.001). In IBS, the FIS score correlated significantly with the cellularity of the lamina propria (r=0.51, p<0.0001) and MCs (r=0.64, p<0.0001). In IBS, the BDI score correlated significantly with MCs (r=0.29, p=0.03). CONCLUSIONS: Elevated MCs counts are a key feature of the low grade inflammatory infiltrate in the caecal mucosa of IBS. Fatigue and depression are associated with mucosal cell counts, in particular MCs suggesting that psychological factors are associated to the low-grade inflammatory infiltrate in IBS.PMID: 18194987


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## SpAsMaN* (May 11, 2002)

I don't get why they claim psychological factors has a role.


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## Kathleen M. (Nov 16, 1999)

Spas, because when you measure the psycho-social side of things, it reliably shows that it is there.Also. Your nervous system TALKS to the mast cells and your mind can actually set them off.ETA: Virtually all diseases or disorder have a psychosocial aspect to them. It just isn't always investigated. Heart disease has quite a few studies on how the psychology of the patient and social support networks effect outcome. You usually do better for most things if you treat the WHOLE patient not just the physical part of them. If effecting the psychology of the patient will help, you are saying we should never do that?Also most of the medications that effect the mind also effect the nerves in the gut. Just because a medication might have a psychological effect does not mean it cannot have other physical effects.ETAmore:Besides if you read the abstract it could be the physical effecting the mental.I suppose we shouldn't look for those things? The body effects the mind just as much as the mind effects the body.K.


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## eric (Jul 8, 1999)

The mast cells in the gut are conneted to the bodies HPA axis which is the bodies stress system, but the system also helps fight infections and is involved in the allergic responce as well as protection for the organism.There is something called neurogenic inflammationTwo really important cells in the gut in IBS are EC or and mast cells.Dr Drossman's comments on foods for IBS Health.Shawn,To say that people with IBS may get symptoms from food intolerances is an acceptable possibility, since the gut will over react to stressors of all types including food (high fat or large volumes of food in particular). Futhermore, there can be specific intolerances. So if you have a lactose intolerance for example, it can exacerbate, or even mimic IBS. Other examples of food substances causing diarrhea would be high consumers of caffeine or alcohol which can stimulate intestinal secretion or with the latter, pull water into the bowel (osmotic diarrhea). The same would be true for overdoing certain poorly absorbed sugars that can cause an osmotic type of diarrhea Sorbitol, found in sugarless gum and sugar substituted foods can also produce such an osmotic diarrhea. Even more naturally, people who consume a large amount of fruits, juices or other processed foods enriched with fructose, can get diarrhea because it is not as easily absorbed by the bowel and goes to the colon where it pulls in water. So if you have IBS, all of these food items would make it worse. However, it is important to separate factors that worsen IBS (e.g., foods as above, stress, hormonal changes, etc.) from the cause or pathophysiology of IBS. Just like stress doesn't cause IBS, (though it can make it worse), foods must be understood as aggravating rather than etiological in nature. The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.Doug http://www.ibshealth.com/ibs_foods_2.htmhttp://www.ibshealth.com/ibsfoodsinfo.htmDr Wood's comments for me"Dr. Jack Wood, a renowned physiologist at The Ohio State University calls the ENS â€œthe little-brain-in-the-gut.â€ "Dear Shawn:Sorry for the delayed reply to your question. I generally agree with Dr. Drosssmanâ€™s response. A subgroup of individuals when they become sensitized to specific molecules in certain foods respond to ingestion of the molecules with symptoms of cramping abdominal pain, fecal urgency and explosive watery diarrhea. These are also the primary symptoms of diarrhea-predominant IBS. *Enteric mast cells, by mechanisms we donâ€™t understand, become sensitized to the food molecule and respond to its presence by releasing a signal to the brain-in-the-gut (ENS) which is interpreted as a threat. The ENS responds by â€œrunningâ€ a program which organizes secretion and motility into a behavior pattern of the bowel, which rapidly clears the threat from the lumen. Because to be effective secretion occurs in large volumes and the contractions that accomplish rapid propulsion are strong, running of the program has the side effects of diarrhea and cramping pain. Big brain input to mast cells during stress activates the mast cells to evoke the symptoms resulting from exposure of the mast cells to sensitizing food antigens. Aside from food allergens and mast cells, certain chemicals such as those in hot peppers, stimulate sensory nerves in the ENS and we are beginning to understand how this can also lead to food-related symptoms that might mimic or exacerbate IBS.*Hope this helps,Jackie (Jack) D. Wood " FYI"You have two brains: one in your head and another in your gut. Dr. Jackie D. Wood is a renowned physiologist at The Ohio State University. He calls the second brain, "the-little-brain-in-the-gut." This enteric nervous system is part of the autonomic nervous system and contains over one hundred million neurons, which is as many as are in the spinal cord. This complex network of nerves lines the walls of the digestive tract form the esophagus all the way down to the colon. *This little brain in the gut is connected to the big brain by the vagus nerves, bundles of nerve fibers running from the GI tract to the head. All neurotransmitters, such as serotonin that are found in the brain are also present in the gut.Dr Wood has discovered that this little-brain-in-the-gut has programs that are designed for our protection and which are very much like computer programs. They respond to perceived threats in the same way that the limbic system or the emotional brain does. So the threat of a gastrointestinal infection can activate the program that increases gut contractions in order to get rid of the infection. The symptoms are abdominal cramping and diarrhea. Dr. Wood has determined that a type of cell found in the body and the gut, called the mast cell, is a key to understanding the connection of the big brain in the head with the little-brain-in-the-gut. Mast cells are involved in defense of the body. In response to certain threats or triggers, such as pollen or infection, mast cells release chemicals, such as histamine, that help to fight off the invader. Histamine is one of the chemicals that causes the symptoms of an allergy or a cold. When an infection of the gut occurs, such as food poisoning or gastroenteritis, the mast cells of the gut release histamine. The little-brain-in-the-gut interprets the mast cell signal of histamine release as a threat and calls up a protective program designed to remove the threat â€" at the expense of symptoms: abdominal pain and diarrhea. **The brain to mast cell connection has a direct clinical relevance for irritable bowel syndrome and other functional gastrointestinal syndromes. It implies a mechanism for linking allostasis and the good stress response to irritable states (e.g., abdominal pain and diarrhea) of the gut. Mast cells can be activated to release histamine in response to perceived psychological stress, whether the stressor or trigger is consciously perceived or not. So the end result is the same as if an infection activated the program in the-little-brain-in-the-gut: abdominal pain and diarrhea."*http://www.parkviewpub.com/nuggets/n5.html


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## Puppy3D (Jul 28, 2004)

Hi all Some time ago I started a thread about mast cells in the german IBS forum www.rds-forum.de It seems a very interesting topic and perhaps these mast cells are key for cure IBS. I`ve read that mast cells in IBS modulate wrong singnals and are the "ermitter" for IBS symptoms like Visceral sensebility, motility dissorders, pain etc. http://www.aerztewoche.at/viewArticleDetai...?articleId=5557The german article I`ve read that how mast cells works faulty after an infection and that`s exactly what I have, post-infected IBS. That means that there is really something biological and organic wrong in gut of IBS people. I know in my case, there is no psychological connection between my brain and my gut. Of course IBS gets bad when I have stress but that`s also true for a lot other disease. I have months without stress and my pain is 24/7 the same, I have the same pain, when I m at the beach in holidays and same when I m at home.







So there must something other, something organic which give me IBS pain the whole years. Does anyone know how to fix the mast cell problem? The article advice to take Ranitidin etc for 4 weeks. Does someone already tried that?


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## eric (Jul 8, 1999)

Puppy3dread thishttp://www.ibsgroup.org/forums/index.php?showtopic=92806


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