Irritable bowel syndrome is significantly associated with somatisation in 840 patients, which may drive bloating

Patel, P.; Bercik, P.; Morgan, D. G.; Bolino, C.; Pintos‐Sanchez, M. I.; Moayyedi, P.; Ford, A. C.

doi:10.1111/apt.13074

Cited by 115Gastrointestinal motility and disordersPsychosomatic Disorders and Their TreatmentsFibromyalgia and Chronic Fatigue Syndrome Research

Irritable bowel syndrome is significantly associated with somatisation in 840 patients, which may drive bloating

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Patel, P., Bercik, P., Morgan, D. G., Bolino, C., Pintos‐Sanchez, M. I., Moayyedi, P., Ford, A. C.·2015·Alimentary Pharmacology & Therapeutics

DOI 10.1111/apt.13074

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Abstract

Summary: Background: Psychological factors may influence persistence and perceived severity of symptoms in irritable bowel syndrome (IBS). Literature suggests that somatisation is associated with IBS. However, the relationship between IBS subtype, symptoms of IBS and somatisation is unclear. Aim: To examine this issue in a large cohort of secondary care patients. Methods: Demographic and gastrointestinal (GI) symptom data were collected from 4224 adult patients via the Rome III questionnaire. Somatisation data were collected using the patient health questionnaire‐12. Mean somatisation score and number of somatic symptoms were compared between IBS patients and controls with minimal GI symptoms, and between IBS subtypes using analysis of variance. Effect of level of somatisation on symptom frequency was compared according to IBS subtype using a χ 2 test. Results: 840 patients met Rome III criteria for IBS, controls were 2137 patients with GI symptoms without IBS. Mean somatisation scores and number of somatic symptoms were higher in IBS vs. controls (P < 0.001), and in mixed stool pattern IBS (IBS‐M), vs. IBS with constipation (IBS‐C) or diarrhoea (IBS‐D) (P < 0.001). High levels of somatisation were more prevalent in IBS‐M (31.7%) vs. IBS‐C (22.5%) or IBS‐D (20.8%) (P = 0.003). For all IBS subtypes, high levels of somatisation were associated with a greater frequency of bloating or abdominal distension prior to logistic regression. Conclusions: IBS is strongly associated with higher levels of somatisation, particularly IBS‐M. Bloating may be associated with higher levels of somatisation, perhaps explaining why it can be difficult to treat.

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Altered visceral sensation in IBS is characterised by central abnormalities in sensory, emotional arousal, and prefrontal cortical regions of the brain.
“Altered visceral sensation in IBS is characterised by central abnormalities in sensory, emotional arousal, and prefrontal cortical regions of the brain.”
From Irritable bowel syndrome (2020) · cites this paper as [25]
The Introduction and Discussion address psychological symptoms, somatisation, and bloating in IBS, but do not describe abnormalities in brain regions. Searches for the quoted phrase and for visceral sensation, cortical regions, and brain imaging found no passage addressing the claimed central abnormalities; page numbers were not available in our copy. (LLM, conf=0.76)
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Background
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Patients with multiple functional gastrointestinal disorders (FGIDs) show increased illness severity: a cross-sectional study in a tertiary care FGID specialty clinic
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The overlap of upper functional gastrointestinal disorders with irritable bowel syndrome in Chinese outpatients: A multicenter study
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Antibiotics and Probiotics for Irritable Bowel Syndrome
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Self-citation
Efficacy of gut–brain neuromodulators in irritable bowel syndrome: an updated systematic review and meta-analysis
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Early response predicts a sustained response to eluxadoline in patients with irritable bowel syndrome with diarrhoea in two Phase 3 studies
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“Irritable bowel syndrome is estimated to affect up to 20% of adults in the US population,(5) is one of the most commonly diagnosed GI disorders,(6) and is associated with higher levels of somatisation, expressed as the feeling of tiredness and the experience of bloating.(7) In the majority of patients, IBS is a chroni…”
Background
Willingness to accept risk with medication in return for cure of symptoms among patients with Rome IV irritable bowel syndrome
Goodoory, V. C., Ng, C. E., Black, C. J., & Ford, A. C. (2022) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.16816 · Cited by 28 · see citing works
Self-citation
Gastrointestinal microbiota and inflammasomes interplay in health and disease: a gut feeling
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“116 In particular, 30%–50% of patients with IBS have been found to suffer from anxiety, depression and mood disorder.”
No increase in prevalence of somatization in functional vs organic dyspepsia: a cross‐sectional survey
Gracie, D. J., Berčík, P., Morgan, D. G., Bolino, C., Pinto-Sánchez, M. I., Moayyedi, P., & Ford, A. C. (2015) · Neurogastroenterology & Motility · doi:10.1111/nmo.12578 · Cited by 27 · see citing works
Self-citation
Distinct associations of DSM-5 Somatic Symptom Disorder, the Diagnostic Criteria for Psychosomatic Research-Revised (DCPR-R) and symptom severity in patients with irritable bowel syndrome
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Symptom severity and clinical characteristics of patients with bloating
Gardiner, C. P., Singh, P., Ballou, S., Hassan, R., Yu, V., Lembo, A. J., Nee, J. W., & Iturrino, J. (2021) · Neurogastroenterology & Motility · doi:10.1111/nmo.14229 · Cited by 24 · see citing works
Irritable Bowel Syndrome: News from an Old Disorder
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Interactions between symptoms and psychological status in irritable bowel syndrome: An exploratory study of the impact of a probiotic combination
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Gut microbiota signatures and modulation in irritable bowel syndrome
Marasco, G., Cremon, C., Barbaro, M. R., Stanghellini, V., & Barbara, G. (2022) · Microbiome Research Reports · doi:10.20517/mrr.2021.12 · Cited by 22 · see citing works
Novel Irritable Bowel Syndrome Subgroups Are Reproducible in the Global Adult Population
Black, C. J., Houghton, L. A., West, R. M., Bangdiwala, S. I., Palsson, O. S., Sperber, A. D., & Ford, A. C. (2024) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.05.042 · Cited by 21 · see citing works
Self-citation
Characteristics of, and natural history among, individuals with Rome IV functional bowel disorders
Goodoory, V. C., Houghton, L. A., Black, C. J., & Ford, A. C. (2021) · Neurogastroenterology & Motility · doi:10.1111/nmo.14268 · Cited by 19 · see citing works
Self-citation
Experiencing multiple concurrent functional gastrointestinal disorders is associated with greater symptom severity and worse quality of life in chronic constipation and defecation disorders
Kaplan, A. I., Mazor, Y., Prott, G. M., Sequeira, C., Jones, M., & Malcolm, A. (2022) · Neurogastroenterology & Motility · doi:10.1111/nmo.14524 · Cited by 16 · see citing works
The Intestinal Gas Questionnaire (IGQ): Psychometric validation of a new instrument for measuring gas‐related symptoms and their impact on daily life among general population and irritable bowel syndrome
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Systematic review and meta-analysis of calculating degree of comorbidity of irritable bowel syndrome with migraine
Todor, T., & Fukudo, S. (2023) · BioPsychoSocial Medicine · doi:10.1186/s13030-023-00275-4 · Cited by 14 · see citing works
Predictors of response to low-dose amitriptyline for irritable bowel syndrome and efficacy and tolerability according to subtype: post hoc analyses from the ATLANTIS trial
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“…participant level, IBS severity at baseline on the IBS severity scoring system (IBS-SSS),[22] time from diagnosis, IBS-associated somatic symptoms,[23] assessed using the Patient Health Questionnaire-12 (PHQ-12),[24] anxiety and depression scores via the Hospital Anxiety and Depression Scale…”
Self-citation
Factors related to irritable bowel syndrome and differences among subtypes: A cross-sectional study in the UK Biobank
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“4%), with the feeling of exhaustion all the time or having low energy as the most disturbing somatic symptom (Patel et al., 2015).”
Background
Health problems associated with irritable bowel syndrome: analysis of a primary care registry
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Hypnotherapy and IBS: Implicit, long-term stress memory in the ENS?
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Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
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Poor predictive value of lower gastrointestinal alarm features in the diagnosis of colorectal cancer in 1981 patients in secondary care
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Self-citation
Derivation and validation of a diagnostic test for irritable bowel syndrome using latent class analysis
Sood, R., Gracie, D. J., Gold, M. J., To, N., Pinto-Sánchez, M. I., Berčík, P., Moayyedi, P., Ford, A. C., & Law, G. R. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13949 · Cited by 11 · see citing works
“The current preferred approach to making a diagnosis of IBS is via symptom-based criteria, of which the Rome IV criteria are the gold-standard,1 although their accuracy has yet to be assessed independently.11 Their predecessor, the Rome III criteria,12 were rarely used in routine clinical care, partly as a consequence…”
ResultInfluentialSelf-citation
Altered Structural Covariance of Insula, Cerebellum and Prefrontal Cortex Is Associated with Somatic Symptom Levels in Irritable Bowel Syndrome (IBS)
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Prevalence of extra‐intestinal symptoms according to irritable bowel syndrome subtype
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Irritable bowel syndrome in women: Association between decreased insular subregion volumes and gastrointestinal symptoms
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A prospective comparison of UK and Malaysian patients with irritable bowel syndrome in secondary care
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Cross‐lagged analyses between gastrointestinal symptoms, psychological distress, and disability in emerging adults
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Diagnostic strategy of irritable bowel syndrome: a low- and middle-income country perspective
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“66 A separate study conducted www.irjournal.org in Iran found that those who met the symptom criteria for IBS had a higher rate of parasitic infections, specifically Blastocystis hominis and G. lamblia , compared to the healthy individuals.”
Background
Evaluation of depression, anxiety, alexithymia, attachment, social support and somatization in functional dyspepsia
Kani, H. T., Dural, U., Kani, A. S., Yanartaş, Ö., KIZILTAŞ, Ş., Enc, F. Y., Atuğ, Ö., Deyneli, O., Kuşçu, K., & İmeryüz, N. (2018) · Psychiatry and Clinical Psychopharmacology · doi:10.1080/24750573.2018.1480081 · Cited by 8 · see citing works
Low-dose titrated amitriptyline as second-line treatment for adults with irritable bowel syndrome in primary care: the ATLANTIS RCT
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Psychological profiles of irritable bowel syndrome patients with different phenotypes
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Clinical Characteristics of Patients Presenting With Bloating as a Predominant Symptom
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Group comparison of individuals with and without irritable bowel syndrome in terms of psychological and lifestyle-related factors
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“Similarly, it has been well known that IBS is associated with various somatic problems such as chronic fatigue, back pain, headache (53,54), and fibromyalgia (55).”
Background
Pathogenesis of irritable bowel syndrome
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“Additionally, somatization has been associated with IBS, particularly the mixed subtype (IBS-M), with one study reporting that 32% of these patients exhibited this form of psychological distress (25).”
Somatization Mediates the Relationship Between Childhood Trauma and Pain Ratings in Patients with Irritable Bowel Syndrome
Schubach, A., Quigley, B. M., Lackner, J. M., & Gudleski, G. D. (2024) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000001974 · Cited by 5 · see citing works
“30 Childhood trauma exposure is positively correlated with somatic preoccupation, 31 and childhood sexual abuse is associated with a 3 times greater risk of adult conversion disorder.”
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Editorial: subgroups in irritable bowel syndrome—more than just diarrhoea and constipation?
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The role of incongruence between the perceived functioning by patients and clinicians in the detection of psychological distress among functional and motor digestive disorders
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“Indeed, anxiety or depression symptoms affect 20–40% IBS patients [30] and somatization scores are elevated in them [31].”
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Effect of physical activity on the severity of irritable bowel syndrome (IBS) symptoms
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Irritable Bowel Syndrome
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Efficacy and Safety of the Enterosorbent Silicolgel in Irritable Bowel Syndrome, IBS‐D and IBS‐M : A Randomized, Double‐Blind, Placebo‐Controlled, Multi‐Center Trial
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Efficacy of the Enteroadsorbent Silicol®gel in Adults with Irritable Bowel Syndrome Subtypes IBS-D or Mixed: Observational Open-Label Study
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“Recent reviews, including evidence from randomized controlled trials, conclude that a low-FODMAP dietary should be the first dietary approach to manage suspected food intolerance in IBS.1,3Y8,11Y17 FODMAP is a group of foods that encompass many of the CHOs found in the typical Western diet, making the list of foods to…”
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“The on average moderate level of psychosocial comorbidity in the pre-sent study was compatible with the established association be-tween DGBIs and mental health [8, 9].”
Association of Irritable Bowel Syndrome with Somatization
Mugheri, A. H., Lakho, S., Balouch, A. H., Unar, F., Bozdar, H. N., & Samo, K. J. (2022) · Pakistan Journal of Medical and Health Sciences · doi:10.53350/pjmhs22164337 · Cited by 1 · see citing works
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“SIRS, We read with interest the article by Patel and others who evaluated the relationship between IBS subtype, symptoms of IBS and somatisation.(1) The authors found that IBS is strongly associated with higher levels of somatization, and bloating may be associated with higher levels of somatisation.”
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“The model is an important step towards a more definitive symptom-based diagnostic criterion for IBS.”
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“The authors only include a small set of questions addressing somatisation, which may be associated with certain functional GI symptoms [6].”
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Editorial: recognising the efficacy of licensed drug therapies for irritable bowel syndrome on bloating—a step in the right direction for targeted treatment? Authors' reply
Nelson, A. D., Black, C. J., Houghton, L. A., Lugo‐Fagundo, N. S., Lacy, B. E., & Ford, A. C. (2021) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.16443
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Letter: irritable bowel syndrome is significantly associated with somatisation
Dai, C., Jiang, M., & Sun, M. (2015) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.13114 · Cited by 1 · see citing works
Bloating in Irritable Bowel Syndrome Is Associated with Symptoms Severity, Psychological Factors, and Comorbidities
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Association of Irritable Bowel Syndrome with Somatization
Mugheri, A. H., Lakho, S., Balouch, A. H., Unar, F., Bozdar, H. N., & Samo, K. J. (2022) · Pakistan Journal of Medical and Health Sciences · doi:10.53350/pjmhs22164337 · Cited by 1 · see citing works
Increased psychological distress and somatization in patients with irritable bowel syndrome compared with functional diarrhea or functional constipation, based on Rome IV criteria
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Authors: Patel, P., Bercik, P., Morgan, D. G., Bolino, C., Pintos‐Sanchez, M. I., Moayyedi, P., & Ford, A. C.
Affiliations: University of Leeds (GB)
Gastroenterology Division Health Sciences Center Farncombe Family Digestive Health Research Institute McMaster University Hamilton ON Canada
St. Joseph’s Healthcare Hamilton (CA)
McMaster University (CA)
Corresponding author: Ford, A. C.
ORCID: Moayyedi, P.
Ford, A. C.
Venue: Alimentary Pharmacology & Therapeutics
Publisher: Wiley
Published: 2015-01-14
Volume: 41
Issue: 5
Pages: 449-458
ISSN: 0269-2813 (ISSN-L)
1365-2036
DOI: 10.1111/apt.13074
OpenAlex: W2033219095
Cited by: 115
References: 38
Citations by year: 2026: 1 · 2025: 8 · 2024: 10 · 2023: 20 · 2022: 14 · 2021: 10 · 2020: 10 · 2019: 6 · 2018: 4 · 2017: 10 · 2016: 9 · 2015: 12
FWCI: 12.13
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Alimentary Pharmacology & Therapeutics (publishedVersion)
PubMed (publishedVersion)
White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
Funders: Canadian Association of Gastroenterology
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords: irritable bowel syndrome, somatization, bloating, abdominal distension, IBS subtypes, IBS-M, irritable bowel syndrome with constipation, diarrhea-predominant irritable bowel syndrome, psychological factors, Rome III criteria, symptom severity
MeSH terms: Adult, Constipation, Diarrhea, Female, Flatulence, Humans, Male, Middle Aged, Surveys and Questionnaires, Severity of Illness Index, Socioeconomic Factors, Somatoform Disorders, Irritable Bowel Syndrome

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Irritable bowel syndrome is significantly associated with somatisation in 840 patients, which may drive bloating

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