Psychologic considerations in the irritable bowel syndrome

Psychologic symptoms are often found in medical clinic patients with the irritable bowel syndrome (IBS), but people with similar bowel symptoms who have not consulted a doctor are psychologically normal. This finding suggests that psychologic distress does not cause bowel symptoms but does influence the decision to seek treatment. Depression and a tendency to somatize (hypochondriasis) are common findings in clinic patients with IBS. Psychologic stress may precipitate exacerbations of bowel symptoms in anyone, but the magnitude of the response appears to be greater in IBS patients. Tricyclic antidepressant medications, brief psychotherapy focused on stress management, and hypnotherapy have been found to be beneficial for both the bowel symptoms and psychologic symptoms.