Attention in Irritable Bowel Syndrome: A Systematic Review of Affected Domains and Brain-Gut Axis Interactions

Abstract

BackgroundIrritable Bowel Syndrome (IBS) is a prevalent functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits, significantly impacting patients quality of life. Recent research suggests that attention may be affected in individuals with IBS, potentially influencing symptom perception and emotional distress. ObjectiveThis systematic review aims to investigate the relationship between attention and IBS, focusing on the affected domains of attention and the interactions within the brain-gut axis. MethodsA comprehensive literature search was conducted across multiple databases, including MEDLINE/PubMed, PsychINFO, and Scopus, from January 1990 to December 2024. Studies were included if they assessed attention in adult IBS patients and employed valid measurement tools. A total of 24 studies were selected for analysis, encompassing various methodologies, including neuroimaging and behavioral assessments. ResultsThe findings indicate that IBS patients exhibit significant attentional biases, particularly towards gastrointestinal-related stimuli, reflecting heightened sensitivity and hypervigilance. Specific domains of attention, including selective attention, sustained attention, and pre-attentional processing, were identified as being affected. The review highlights the role of psychological factors, such as anxiety and depression, in modulating attention in IBS. Neuroimaging studies revealed altered brain activation patterns in regions associated with attention and emotional processing, suggesting a complex interplay between cognitive function and the brain-gut axis. ConclusionThis systematic review underscores the multifaceted nature of attention in IBS, revealing specific attentional deficits and biases that may contribute to symptom exacerbation and emotional distress. The findings emphasize the need for further research to explore the underlying mechanisms and potential therapeutic interventions aimed at addressing attention in IBS patients.