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Role of Sertraline as a Mono-therapy in Treatment of Irritable Bowel Syndrome and Associated Psychological Problems: A Singleblinded Randomized Controlled Trial

Background: Irritable bowel syndrome (IBS) is considered one of the most common functional gastrointestinal disorders. The pathogenesis of IBS is still unknown, as it has both physiological and psychological factors. Being a multifactorial disorder, the treatment of IBS is thereby challenging and also conflicting. Conventional therapy might have an effect in mild and recently diagnosed cases but for some while and some extent. So, antidepressant medications were proposed to treat IBS with long lasting effect. This study aimed to compare effect of sertraline to placebo in treatment of IBS and its comorbid anxiety and/or depressive symptoms.

Methods: 55 patients were recruited from outpatient clinics at Assiut University Hospitals and were diagnosed as irritable bowel syndrome according to Rome III criteria. Patients underwent Hamilton rating scale for anxiety and depression to assess their level of anxiety and depression respectively. Patients were divided into two groups, one group of patients received sertraline and the second group received placebo. Blinding was concealed throughout the clinical trial. Assessment of patients was done after four weeks regarding their bowel symptoms, anxiety, and depressive symptoms.

Results: Sertraline group showed significant reduction of bowel symptoms in 20 patients (66.67%) versus 8 patients (32%) who received placebo (P=0.001). Also, there was significant reduction in anxiety and depressive scores in Hamilton rating scale for anxiety and depression respectively (P=0.001).

Conclusion: Sertraline is superior to placebo in treatment of irritable bowel syndrome especially in those who have comorbid anxiety and depression.


Ihab M Saleh, Khaled O Mohamed, Muhammad A El-Masry and Nageh F Kamel

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