Depression Promotes the Onset of Irritable Bowel Syndrome through Unique Dysbiosis in Rats

BACKGROUND/AIMS: Although studies using conventional animal models have shown that specific stressors cause irritable bowel syndrome (IBS), it is unclear whether depression itself causes IBS. Our aim was to establish a rat model to determine if depression itself promotes the onset of IBS and to elucidate the role of gut microbiota in brain-gut axis pathogenesis during coincident depression and IBS. METHODS: Rat models of depression were induced using our shuttle box method of learned helplessness. Visceral hypersensitivity was evaluated by colorectal distension (CRD) to diagnose IBS. Gut microbiota compositions were analyzed using high-throughput sequencing. In the subanalysis of rats without depression-like symptoms, rats with posttraumatic stress disorder (PTSD) were also examined. RESULTS: The threshold value of CRD in depressed rats was significantly lower than that in control rats. Microbial community analysis of cecal microbiota showed that the relative abundance of Clostridiales incertae sedis, the most prevalent microbe, was significantly lower in depressed rats than in control rats. The distribution pattern of the microbiota clearly differed between depressed rats and control rats. Neither visceral hypersensitivity nor the composition of gut microbiota was altered in rats with PTSD-like phenotypes. CONCLUSIONS: Our rat model of depression is useful for clarifying the effect of depression on IBS and suggests that depression itself, rather than specific stressors, promotes the onset of IBS. Further, we provided evidence that various psychiatric diseases, viz., depression and PTSD, are associated with unique gut microbiota profiles, which could differentially affect the onset and progression of coincident IBS.

Questionnaire survey of Home-Visit Nursing Care of elderly Diabetic Patients / 日本農村医学会雑誌

The number of elderly diabetic patients has continued to increase year by year. Home-visit nursing care is beneficial to homebound elderly diabetic patients and there is a large number of senior citizens utilizing this form of health service. We conducted a questionnaire survey of home-visit nursing care of elderly diabetic patients. Those queried were participants in the diabetes workshop. Eighty-five of them responded to our questionnaire.The results showed that 87% of the respondents experienced care of diabetic patients and acute complications of hypoglycemia and hyperglycemia as well. It was also found that many home helpers extended assistance in drug compliance, indicating that home helpers play an important role in the medical care of elderly diabetic patients.On the other hand, many problems became apparent such as lack of observation of foot care, lack of knowledge of methods of treating hypoglycemia, and inadequate observation of drug compliance due to the limited availability of home visit time.Training and collaboration of local home-visit nursing care personnel are considered necessary in the future in order to improve on the home care of elderly diabetic patients.