Cognitive impairment in irritable bowel syndrome (IBS): a systematic review

Abstract

Background: Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder which is characterized by altered bowel habits. A growing number of studies investigate the association between IBS and cognitive impairments. Current studies report conflicting results regarding cognitive impairment in IBS patients. We therefore conducted the first systematic review to examine the association between IBS and cognitive impairment and identify the types of cognitive domain involved.

Study design: Eight databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, PsycINFO, ScienceDirect, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature Database (CBM)) were searched from the inception date up till 15 February 2018. Observational studies published in English or Chinese were independently appraised, and data was extracted, by two reviewers using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The findings were synthesized using a narrative approach.

Results: Twelve studies met the inclusion criteria. Our findings suggested that IBS patients exhibited attentional bias towards GI sensation words and emotionally negative words. There was insufficient evidence of evidences to show that IBS patients had cognitive deficits in memory, intelligence, executive functions and general cognitive functions. A number of limitations were identified, including small sample, limited cognitive domain inclusion, lack of study details, and management of confounding variables.

Conclusion: There is evidence of attentional bias in individuals with IBS; the evidence on cognitive impairment was either inconclusive or insufficient in other cognitive domains. Further studies are needed to confirm prevalence rates and examine potential mechanisms.