Transcript CHAPTER 21: The Psychology of Irritable Bowel Syndrome

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:
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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
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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