El papel de los antidepresivos en el manejo del síndrome de intestino irritable / The role of antidepressants in the management of irritable bowel syndrome (IBS)

RESUMEN

El síndrome de intestino irritable es una entidad compleja, de etiología desconocida y fisiopatología parcialmente comprendida, de frecuente ocurrencia y con múltiples tratamientos descritos. Se ha estudiado especialmente la relación de los factores psicosociales con la génesis y presentación de la entidad. El paciente requiere un enfoque que contemple sus síntomas, la reacción ante su enfermedad y su entorno. De los múltiples tratamientos descritos, los medicamentos antidepresivos han recibido considerable atención pero su utilidad clínica no es clara. El objetivo del presente trabajo es realizar una revisión enfocada de la literatura sobre las bases fisiopatológicas, la presencia de comorbilidad psiquiátrica y la utilidad clínica del uso de antidepresivos en este síndrome.

ABSTRACT

Irritable Bowel Syndrome (IBS) is a complex entity whose etiology is unknown and whose physiopathology is incompletely known. It occurs frequently, and many treatments for it have been described. The relation of psycho-social factors to the genesis and presentation of IBS has been studied with special attention. The approach to treating IBS patients requires contemplation of the patient’s symptoms and reactions to his or her illness and environment. Of the multiple treatments for IBS which have been described, antidepressants have received considerable attention although their clinical utility is still not clear. The objective of this work is to review the literature regarding the physiopathological basis of IBS, comorbidities with psychiatric disorders, and the clinical usefulness of antidepressants for treating irritable bowel syndrome.