Saudi Journal of Gastroenterology
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Year : 2014  |  Volume : 20  |  Issue : 5  |  Page : 328
Authors response

Department of Psychiatry, King Saud University, PO Box 7805, Riyadh - 11472, Kingdom of Saudi Arabia

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Date of Web Publication25-Sep-2014

How to cite this article:
Alosaimi F. Authors response. Saudi J Gastroenterol 2014;20:328

How to cite this URL:
Alosaimi F. Authors response. Saudi J Gastroenterol [serial online] 2014 [cited 2022 Dec 3];20:328. Available from:


We thank Tasci et al. for their interest and thoughtful comments regarding our recently published study, which shows that depression and anxiety are common comorbidities in gastroenterological outpatient population, especially those who have a chronic course of multiple gastrointestinal complaints. [1] We acknowledge that our study did not look at biological markers that may add to the growing body of literature emphasizing gut as a second brain. [2] Recent neurobiological findings showed that a complex, bidirectional communication system occurs via neural, immunological, and hormonal routes that not only ensures the proper maintenance of gastrointestinal homeostasis and digestion but is likely to have multiple effects on affect, motivation, and higher cognitive functions, including intuitive decision making. Furthermore, derangement of the gut-brain system has been implicated in many disorders, including functional and inflammatory gastrointestinal disorders, obesity, and eating disorders. [3]

Finally, we like to share with our readers recent, reassuring data about the debatable association of the widely used antidepressants; selective serotonin reuptake inhibtors (SSRIs), and upper gastrointestinal bleeding (UGIB). One meta-analysis showed that the number needed to harm in a low-risk population was 3177, and in a high-risk population it was 881. The risk of UGIB was further increased with the use of both SSRI and nonsteroidal anti-inflammatory drug medications (odds ratio = 4.25, 95% confidence interval = 2.82, 6.42). [4] The second meta-analysis showed similar results. Moreover, it found no significant increase in the risk of developing UGIB among patients receiving concurrent acid-suppressing drugs. [5]

   References Top

1.Alosaimi FD, Al-Sultan O, Alghamdi Q, Almohaimeed I, Alqannas S. Association of help-seeking behavior with depression and anxiety disorders among gastroenterological patients in Saudi Arabia. Saudi J Gastroenterol 2014;20:233-40.  Back to cited text no. 1
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2.Al Omran Y, Aziz Q. The brain-gut axis in health and disease. Adv Exp Med Biol 2014;817:135-53.  Back to cited text no. 2
3.Mayer EA. Gut feelings: The emerging biology of gut-brain communication. Nat Rev Neurosci 2011;12:453-66.  Back to cited text no. 3
4.Anglin R, Yuan Y, Moayyedi P, Tse F, Armstrong D, Leontiadis GI. Risk of uppergastrointestinal bleeding with selective serotonin reuptake inhibitors with or without concurrent nonsteroidal anti-inflammatory use: A systematic review and meta-analysis. Am J Gastroenterol 2014;109:811-9.  Back to cited text no. 4
5.Jiang HY, Chen HZ, Hu XJ, Yang W, Deng M, Zhang YH, et al. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal bleeding: A systematic review and meta-analysis. Clin Gastroenterol Hepatol 2014. [Epub ahead of print].  Back to cited text no. 5

Correspondence Address:
Fahad Alosaimi
Department of Psychiatry, King Saud University, PO Box 7805, Riyadh - 11472
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.141703

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