It has long been recognized that depression can lead to GI symptoms. But do all GI symptoms in the setting of depression mean only depression? A recent study by Jonathan Blackwell et al at St George’s University of London found that depression, in the absence of prior GI symptoms, is not associated with subsequent development of IBD. However, depression with GI symptoms should prompt investigation for IBD. A retrospective study was done with access to the records of 15,000 IBD patients, plus a similar number of controls. There was an excess of prevalent depression 5 years before IBD diagnosis relative to controls (UC: 3.7% vs 2.7%, CD 3.7% vs 2.9%). Individuals with GI symptoms prior to the diagnosis of depression had increased adjusted risks of developing UC and CD compared with those without depression (UC: OR 1.47, 95% CI 1.21 to 1.79; CD: OR 1.41, 95% CI 1.04 to 1.92).

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