.The RELATIONSHIP BETWEEN SYMPTOMS SEVERITY, MENTAL HEALTH, LIFESTYLE FACTORS, AND GUT MICROBIOME AMONG IRRITABLE BOWEL SYNDROME PATIENTS, A CROSS-SECTIONAL STUDY,WEST BANK,PALESTINE
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Date
2025-03-24
Authors
Sa'd al deen Yasmeen
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Publisher
An-Najah National University
Abstract
Background: irritable bowel syndrome (IBS) is a popular functional disorder, which is characterized by chronic abdominal pain, variation in bowel habits and bloating. IBS is one of the global disorders that constitute a burden on both healthcare organizations and patients' quality of life. Its pathophysiology is complex and involves an interaction of psychosocial and environmental factors. Also, dysbiosis of gut microbiota and gut-brain axis plays an important role in this disorder and affects patients' mental health which can affect symptoms of IBS. So the study objective is to determine the relationship between the symptoms of IBS patients and their mental health, life style, certain types of diet, and gut microbiota diversity and compare it with healthy control. Methods: in this cross-sectional study, we aimed to find the relationship between IBS patients' mental health, physical activity, MEDAS, and gut microbiota composition, and compare it between healthy control and between themselves according to the severity of symptoms. The total number of IBS patients who participated in this study was 237 and 30 healthy control participants. All participants fulfilled the questionnaire to evaluate their mental health, physical activity, adherence to the MEDAS diet, smoking habits, and the severity of symptoms for IBS patients to assess their severity of symptoms using the Birmingham IBS questionnaire. For analysis of gut microbiota, stool samples were collected from all the control and 30 IBS matching patients. DNA extraction was followed by a semi-quantitative PCR to quantify the following bacterial species (Butyricicoccus, Enterobacteriaceae, Fecalibacter, Akkermansia, Bacteroides, Bifidobacterium, Escherichia, Streptococcus, Lactobacillus, and Roseburia) from all stool samples. Statistical analyses were performed to evaluate the relationship between mental health, physical activity, adherence to the MEDAS diet, smoking habits, and severity of IBS symptoms, as well as between the patient and healthy control. Results: Microbiota diversity analysis using alpha and beta diversity, got a good variance between healthy control and IBS patients, which was evaluated using Bray-Curtis dissimilarity with a value of 0.88. Mental health distress, physical activity, sleep problems, duration of, and smoking had a significant relationship between them, while no significant relationship was detected between BMI and MEDAS diet adherence. When using the Shannon index to assess alpha diversity between groups of patients with different severity of symptoms, different microbiota diversity was shown, with a significant relationship between smoking, sleep problems, and mental health distress. While no variation was shown between BMI, physical activity, and MEDAS diet adherence. Conclusion: This study shows differentiation in gut microbiota diversity between IBS patients and healthy controls. As well as, between groups of patients with different severity of symptoms. There is a significant relationship between mental health distress, smoking, and sleep problems for both. Physical activity between IBS patients and healthy control got significant relationship. These findings emphasize the significance of taking into consideration managing IBS patients based on their lifestyle and mental health status, together with traditional medication which can improve gut microbiota diversity.