CHAPTER 21: The Psychology of Irritable Bowel Syndrome

Introduction Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal (GI) tract that affects approximately 10% to 15% of the population. – Abdominal pain/discomfort – Diarrhea – Constipation

Introduction Majority of IBS patients are women. – Most prevalent during ages 40 to 50 but can occur at any time during lifespan. Biopsychosocial model of IBS – IBS is a multifactorial disease. – Reflects the complex interplay among biology, life experiences, psychological processes, and societal influences.

Biological Factors IBS involves multiple symptoms and processes. – Emotional and/or chemical changes in the brain can affect signals sent to gut. Medical comorbidity: – Bloating – Fibromyalgia – Back pain – Urogenital and gynecological symptoms – Sleep problems

Psychological Factors Cognitive-affective processes have a direct impact on GI physiology and motility. Comorbid psychiatric disorders – Anxiety – Visceral anxiety – Mood – Somatization – Psychological stress – Coping

Social Factors Stigma Symptoms not taken seriously Poorly understood by others Social support may reduce shame and stigma associated with IBS.

IBS Across the Female Lifespan Early Life Experiences Violence Against Women: Physical, Sexual, and Emotional Abuse – IBS among women veterans Hormones, Menstrual Cycle, Menopause

IBS Across the Female Lifespan Interpersonal Relationships and Family Issues Unique to Middle and Advanced Age – Colorectal cancer – Constipation – Fecal incontinence

Management of IBS Dietary Management – Food intolerances are common Psychological Management – Interpersonal psychotherapy (IPT) – Gut-directed hypnotherapy – Cognitive-behavioral therapy (CBT) – Educational support groups

Conclusion and Future Directions Continuing to address gender differences in IBS Relationship between IBS and disordered eating/body image concerns Consideration of sex/gender as potential mediators or moderators of disease outcomes Impact of ethnicity and race on experience of IBS