Stress may lead to exacerbations of ulcerative colitis
Last Updated: 2006-09-06 13:59:01 -0400 (Reuters Health)
By Michele Rizzo

NEW YORK (Reuters Health) - Acute psychological stress induces systemic and mucosal proinflammatory responses, and this might be particularly detrimental to patients with ulcerative colitis (UC), according to researchers.

"Recent studies suggest that life events and chronic stress increase the risk of relapse in inflammatory bowel disease," Dr. David S. Rampton, of Royal London Hospital, UK, and colleagues write in the August issue of Gastroenterology. In the current study, the researchers examined the effects of acute psychologic stress on systemic and rectal mucosal inflammatory measures in patients with inactive UC.

A total of 25 patients with inactive UC and 11 healthy volunteers underwent an experimental stress test. Another 10 UC patients and 11 volunteers were subject to a control procedure.

Pulse and systolic and diastolic blood pressures were increased with stress in both UC patients and volunteers. In both groups, stress increased LPS-stimulated tumor necrosis factor (TNF) alpha by 54% and Interleukin-6 by 11%. Stress also increased leukocyte count by 16%, natural killer cell count by 18% and platelet activation by 65%.

Furthermore, platelet-leukocyte aggregate formation rose by 25%, mucosal TNF-alpha release by 102% and reactive oxygen metabolite by 475%. Stress also reduced rectal mucosal blood flow by 22%.

No differences were observed between UC patients and healthy volunteers in terms of the changes elicited by the stress protocol. None of the variables measured were changed with the control protocol.

Dr. Rampton said in an interview with Reuters Health that "it is possible that new therapies aimed at reducing mental stress could have a beneficial role in preventing flare up of ulcerative colitis."  Moreover, he added that "it is possible that mental stress could produce similar changes in other organs."

Gastroenterology 2006;131:410-419.

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