Psychological Factors and IBS

Some people with irritable bowel syndrome (IBS) report psychological symptoms such as depressed mood or anxiety. This occurs mainly in persons with more severe symptoms and in patients seen in highly specialized (tertiary) medical care referral centers.

Not all people with IBS symptoms have symptoms of psychological distress.

Psychological factors are not a primary cause of IBS. They may influence how a person seeks to manage and deal with IBS.

Emotional distress may be associated with a worsening of IBS symptoms. Not uncommonly, people with IBS may develop symptoms while eating at restaurants and social gatherings.

Symptoms may induce an appropriate but unwanted anticipatory anxiety due to the severity, unpredictability, and associated negatively perceived consequences of having an “attack.” This may result in continuing symptom occurrence and set up a vicious cycle between emotional distress, symptoms, and personal management strategies.

In other words, concerns, worries, and fears can be due to the symptoms experienced by persons with IBS rather than due to general anxiety.

Many people experience abdominal pain and constipation or diarrhea without any evidence of anxiety, depression, or other psychological symptoms. Stressful events like losing a job or becoming embroiled in an argument are events that can cause a transient change in bowel habits and even abdominal pain for most people.

This response in people with IBS is more pronounced on a recurrent or chronic basis. Therefore, they are more likely to experience symptoms or experience worse symptoms when they are exposed to a significant stressor.

Learn more about stress in IBS

Other people are troubled by unresolved emotional issues that may have arisen in childhood or adulthood. Addressing these issues with an empathetic health care provider, who can refer the patient for counseling, would be important to improve IBS symptoms and daily function in these individuals.

Learn more about psychological treatments for IBS


Source: Adapted from IFFGD Publication #101 revised and updated by Douglas A. Drossman, MD, Drossman Gastroenterology PLLC, Chapel Hill, NC.

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IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.

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