Monday, 14 April 2014

Neurology of inflammatory bowel diseases

The paper by Ben-Or and colleagues [1] talking about a neurologic profile present in a small participant cohort of children and adolescents diagnosed with an inflammatory bowel disease (IBD) caught my eye recently. Their findings reporting that over two-thirds of their paediatric participant group diagnosed with IBD also "exhibited neurologic manifestations" provides some compelling preliminary evidence for further investigation in this area.

Outside of reports of headache and dizziness, the presentation of attention-deficit hyperactivity disorder (ADHD), hypotonia and "sensory complaints" comorbid to IBD shines a spotlight on the so-called 'gut-brain axis'. That being said the fact that "seizures and neuropsychiatric disorders were less characteristic" between IBD cases and asymptomatic controls may also have some important implications for various conditions including the primary topic of this blog, the autism spectrum conditions.

I'm not on this occasion going to dissect the Ben-Or findings too much aside from pointing you in the direction of some other research which may very well tie into their findings. I've talked before about research on other bowel-related conditions suggestive of potentially important neurological and behavioural links. Think coeliac disease and the the ataxia story as one example mentioned in a previous post (see here). I'd also draw your attention to some work in the autism research domain talking about a possible link between functional bowel habit issues and the presentation of anxiety and sensory symptoms (see here). Granted, it is a leap from a diagnosis of IBD to the presentation of constipation or diarrhoea not necessarily due to an IBD (or at least that's what was thought) but one might imagine that further investigation would be indicated in light of the Ben-Or data.

Reiterating the gut-brain link which seems to be appearing with ever-greater frequency these days, I'm minded to suggest that further research be directed to looking at the possible mechanisms to account for any relationship. The usual triad of issues: intestinal (gut) permeability, the gut microbiota and the gut mucosal immune system spring to mind as potential players in any relationship, but that's all I'll say on the matter for now.


[1] Ben-Or O. et al. The Neurologic Profile of Children and Adolescents With Inflammatory Bowel Disease. J Child Neurol. 2014 Apr 2.

---------- Ben-Or O, Zelnik N, Shaoul R, Pacht A, & Lerner A (2014). The Neurologic Profile of Children and Adolescents With Inflammatory Bowel Disease. Journal of child neurology PMID: 24700662