Being depressed may have little impact on flare ups for patients with inflammatory bowel disease (IBD), researchers have found.

Patients with IBD, which causes the lining of the gut to become inflamed, are accepted to have higher rates of depression than the general population, but whether this makes their disease worse has been unclear.

Now, researchers from Imperial College London and St George’s, University of London investigating the link say there is limited evidence to support the idea that being depressed leads to a deterioration of patients’ bowel conditions. However, they add that the limited available evidence from their review suggests a stronger link with one form of the condition – Crohn’s Disease – over another.

The findings could lead to better treatment of IBD and ultimately, say the researchers, to cost savings for the healthcare system.

During the review, they extracted relevant information from 11 published studies involving patients with IBD, using whether or not their disease worsened as the primary outcome. Three of the studies looked only at patients with UC, four studies looked only at patients with Crohn’s Disease, and the remaining four studies looked at both conditions.

Analysis of this pooled data revealed a lack of evidence to support the idea that depression makes IBD worse. However, the researchers note that there was evidence to suggest depression has more of an effect on symptoms in patients with Crohn’s Disease, compared with Ulcerative Colitis.

Dr Sonia Saxena, from the School of Public Health at Imperial, explained: “This study is about investigating whether stress and depression make inflammatory conditions worse.”

She added: “IBD is associated with major disability during flare ups and patients may have to take expensive drugs, including immunosuppressants, which can have significant side effects and impact on their quality of life.

“We are still trying to untangle how depression and inflammatory bowel conditions could be linked. If being depressed makes things much worse, it’s important we are able to diagnose that. Essentially, if we could make a patient’s gut inflammation better by treating their depression, we could potentially avoid these side effects and improve patients’ quality of life.” Article titled, ‘Systematic Review and Meta–analysis: The impact of a depressive state on disease course in adult inflammatory bowel disease’ was published in the journal Alimentary Pharmacology and Therapeutics.