Gastrointestinal Disorders: Inflammatory Bowel Disease and Irritable Bowel Syndrome

The brain and gut are highly interconnected through bidirectional neural pathways that influence digestive health and illness. Disorders of the gastrointestinal (GI) tract are particularly susceptible to the influence of psychological factors, directly impacting GI function and visceral sensation, as well as affecting behavior patterns and cognitive-emotional processes which can underlie symptom experience. This article focuses on two high impact GI diseases, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), illustrating the role of psychological functioning in disease course and clinical outcomes, as well as the contribution of psychological care to the management of these conditions. The article provides important epidemiological and etiological background on each disease. It presents the unique and overlapping characteristics of IBD and IBS regarding general clinical features, disease-defining symptoms, and common medical and psychiatric comorbidities. Medical diagnostic processes are described along with the value of and approach for psychological evaluation of these patients, including assessment strategies and validated measures for clinically relevant domains (e.g., pain, depression, self-efficacy, quality of life). The current state of evidence for psychological therapies for IBD and IBS, such as cognitive behavioral therapy, hypnosis, and third wave approaches, is examined. Drawing upon cutting edge research, the article provides a contemporary, comprehensive, and concise review of these two disorders, their psychosocial underpinnings, and clinical management. Many clinical pearls supporting applied practice are offered for those looking for a hands-on resource for the growing field of psychogastroenterology.