The systematic review and meta-analysis included 28 randomized controlled trials involving more than 1,700 people. The studies examined were related to cases where people with IBD were treated with some sort of mood intervention.

Dr. Garry Spink, a pain psychologist in Liverpool, New York, who was not involved in the study, explained that mood interventions are treatments that focus on addressing underlying psychological and sociological factors that impact mood.

Some of the types of interventions that the researchers looked at included psychotherapy, antidepressants, and exercise.

The studies selected for analysis also provided measures for inflammatory biomarkers such as C-reactive protein and fecal calprotectin.

The team found that psychotherapy performed better than antidepressants and exercise. Cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based stress reduction were the most effective forms of psychotherapy.

Additionally, the more the treatments improved mood, the more they also improved levels of inflammatory biomarkers.

The scientists said these findings suggest that treatments that improve mood are capable of treating inflammation in IBD as well as inflammation in general.

Why mood interventions might help reduce inflammation

Spink said the short answer as to why mood interventions appear to be beneficial in inflammatory diseases like IBD lies in the mind-body connection.

“In short, our minds and bodies are connected and influence each other,” he explained. “So, the way you view a situation, the behaviors you engage in, and how you perceive your environment influences your body’s reaction and your experience of that environment.”

Spink went on to discuss how increasing depression leads to changes in the immune system, which affects levels of inflammatory markers, which, in turn, leads to high levels of inflammation.

“More specifically related to inflammatory bowel disease, there is a gut-brain connection that is composed of a large number of neural connections from the gut and the brain that communicate both ways,” he added.

“Thus, the gut can affect your mood, and your mood can affect your gut. That is why we sometimes feel ‘sick to our stomachs’ when stressed.”

Spink further explained that this two-way communication plays an important role in directing resources away from the gut in times of stress when we might need them to deal with a threat in our environment.

Melanie Murphy Richter, MS, RDN, who is a Registered Dietitian Nutritionist as well as the Director of Communications and a Medical Science Educator for Prolon, added that any sort of stress, whether real or perceived, is enough to affect the gut lining.

“When stress goes unmodulated, over time, it will cause an imbalance in our gut flora, cultivating a friendly environment for pathogenic (harmful) fungi like yeast and mold to live and grow,” she stated.

“The overgrowth of these microbes can also lead to gut inflammation and can also be a root cause of IBD.”

“More and more practitioners are finding that by focusing on improving mood and mental health, we can significantly reduce inflammatory biomarkers and even CRP levels, a measure of inflammation in the body,” said Richter.

“Other research is diving into the impact of mindfulness practices like meditation on the reduction of inflammation and disease.”

Richter added that mood interventions are “incredibly important” when it comes to managing inflammatory conditions like IBD.

“Even if future research finds that these interventions are only moderately helpful in reducing inflammation and disease progression, the positive impact they play on a person’s outlook on their health conditions and state of life is worth the time and energy spent pursuing them,” she concluded.

The study authors additionally note that IBD medications can be quite expensive, whereas mood interventions, in particular psychotherapy, tend to be relatively affordable. They believe that mood interventions may help make treatment for IBD less expensive as well as more effective.

Takeaway

Researchers have found that mood interventions — including psychotherapy, antidepressants, and exercise — can help reduce the inflammation associated with IBD by 18%.

This might be because there is two-way communication between the gut and brain, allowing resources to be directed away from the gut in times of stress when we need to be able to respond to threats.

In the future, mood interventions could be a less expensive alternative to the medications currently used to treat IBD.