V. Stress and irritable bowel syndrome
Abstract
Different types of stress play important roles in the onset and modulation of irritable bowel syndrome (IBS) symptoms. The physiological effects of psychological and physical stressors on gut function and brain-gut interactions are mediated by outputs of the emotional motor system in terms of autonomic, neuroendocrine, attentional, and pain modulatory responses. IBS patients show an enhanced responsiveness of this system manifesting in altered modulation of gastrointestinal motility and secretion and in alterations in the perception of visceral events. Functional brain imaging techniques are beginning to identify brain circuits involved in the perceptual alterations. Animal models have recently been proposed that mimic key features of the human syndrome.
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IBS is currently conceptualized as a bio-psychosocial disorder involving motor function disturbances, heightened visceral sensitivity, and possibly central nervous system disturbances.
“Although the cause of the disorder remains essentially unknown, IBS is currently conceptualized as a bio-psychosocial disorder with disturbances of motor function, heightened visceral sensitivity, and possibly central nervous system disturbances (4–6).”
From Psychosocial Distress and Somatic Symptoms in Community Subjects With Irritable Bowel Syndrome: A Psychological Component Is the Rule (2009) · cites this paper as [5]
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“This leftward shift of the stimulus response curve in hypersensitive IBS patients has been described earlier42 and could be caused by amplification of the experimental sensory inflow somewhere along the afferent pelvic visceral pathway: (1) at the gut receptor level, (2) in the dorsal horn of the spinal cord, (3) in t…”
BackgroundMethodResultSelf-citationMoloney, R. D., O’Mahony, S. M., Dinan, T. G., & Cryan, J. F. (2015) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2015.00015 · Cited by 167 · see citing works
External and internal influences on disease risk in cats
Buffington, C. A. T. (2002) · Journal of the American Veterinary Medical Association · doi:10.2460/javma.2002.220.994 · Cited by 162 · see citing works
Stengel, A., & Taché, Y. (2008) · Annual Review of Physiology · doi:10.1146/annurev.physiol.010908.163221 · Cited by 158 · see citing works
Relationship of Abuse History to Functional Gastrointestinal Disorders and Symptoms
Leserman, J., & Drossman, D. A. (2007) · Trauma Violence & Abuse · doi:10.1177/1524838007303240 · Cited by 149 · see citing works
“This occurs to a greater degree in patients with IBS who show increased motor, sensory, and autonomic reactivity via these central modulatory systems (Mayer et al., 2001).”
Backgroundvan Tilburg, M. A. L., Palsson, O. S., & Whitehead, W. E. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.03.004 · Cited by 151 · see citing works
“tivity to stress [14]; that is, compared with healthy controls, the same exposure to stress leads to a greater physiological gut response in IBS patients.”
BackgroundAbility of the Normal Human Small Intestine to Absorb Fructose: Evaluation by Breath Testing
Rao, S. S. C., Attaluri, A., Anderson, L., & Stumbo, P. (2007) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2007.04.008 · Cited by 146 · see citing works
The Effect of Life Stress on Symptoms of Heartburn
Naliboff, B. D., Mayer, M., Fass, R., FitzGerald, L., Chang, L., Bolus, R. R., & Mayer, E. A. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000124756.37520.84 · Cited by 146 · see citing works
Self-citationBarreau, F., Cartier, C., Leveque, M., Ferrier, L., Moriez, R., Laroute, V., Rosztoczy, A. I., Fioramonti, J., & Bueno, L. P. (2007) · The Journal of Physiology · doi:10.1113/jphysiol.2006.120907 · Cited by 144 · see citing works
Condition-specific deactivation of brain regions by 5-HT3 receptor antagonist Alosetron
Berman, S. M., Chang, L., Suyenobu, B., Derbyshire, S. W., Stains, J., FitzGerald, L., Mandelkern, M., Hamm, L., Vogt, B., Naliboff, B. D., et al. (2002) · Gastroenterology · doi:10.1053/gast.2002.35990 · Cited by 139 · see citing works
Self-citationMayer, E. A., Tillisch, K., & Bradesi, S. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.03078.x · Cited by 139 · see citing works
Self-citationO’Malley, D., Quigley, E. M. M., Dinan, T. G., & Cryan, J. F. (2011) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2011.04.009 · Cited by 139 · see citing works
“mune up-regulation and are an important consideration in the initiation and persistence of IBS symptom flare-ups (Blanchard et al., 2007; Mayer et al., 2001; O’Mahony et al., 2009; Saito and Talley, 2008).”
BackgroundGrover, M., Herfarth, H. H., & Drossman, D. A. (2008) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2008.08.032 · Cited by 131 · see citing works
Oxytocin ameliorates oxidative colonic inflammation by a neutrophil-dependent mechanism
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Generalized Anxiety Disorder and Medical Illness
Culpepper, L. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.s.7002.04 · Cited by 131 · see citing works
“Few trials have examined the impact of treating GAD in patients with diabetes or of treating diabetes in patients with GAD.”
BackgroundInfluentialChoung, R. S., Locke, G. R., Zinsmeister, A. R., Schleck, C. D., & Talley, N. J. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2009.239 · Cited by 129 · see citing works
Alonso, C., Guilarte, M., Vicario, M., Ramos, L., Ramadan, Z., Antolín, M., Martínez, C., Rezzi, S., Saperas, E., Kochhar, S., et al. (2008) · Gastroenterology · doi:10.1053/j.gastro.2008.03.036 · Cited by 128 · see citing works
IN VIVO MODELS OF INTERSTITIAL CYSTITIS
Westropp, J. L., & Buffington, C. A. T. (2002) · The Journal of Urology · doi:10.1016/s0022-5347(01)69129-8 · Cited by 130 · see citing works
Larauche, M. H., Gourcerol, G., Wang, L., Pambukchian, K., Brunnhuber, S., Adelson, D. W., Rivier, J., Million, M., & Taché, Y. (2009) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00072.2009 · Cited by 129 · see citing works
O’Malley, D., Julio‐Pieper, M., Gibney, S. M., Dinan, T. G., & Cryan, J. F. (2009) · Stress · doi:10.3109/10253890903067418 · Cited by 122 · see citing works
“IBS, which is characterised by abdominal pain and altered bowel habit is contributed to, and exacerbated by stress, in addition to early life experiences and genetics (Lowman et al. 1987; Mayer et al. 2001).”
BackgroundLackner, J. M., Lou Coad, M., Mertz, H. R., Wack, D. S., Katz, L. A., Krasner, S. S., Firth, R., Mahl, T. C., & Lockwood, A. H. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.05.002 · Cited by 120 · see citing works
“Cognitive factors can modulate pain experience (Accarino, Azpiroz, & Malagelada, 1997; Naliboff et al., 2001), induce IBS-like colonic motor activity (Almy et al., 1949), heighten stress reactivity (Mayer et al., 2001) and alter brain function (Naliboff et al., 2001).”
BackgroundMayer, E. A., Berman, S. M., Derbyshire, S. W. G., Suyenobu, B. Y., Chang, L., Fitzgerald, L., Mandelkern, M. A., Hamm, L. R., Vogt, B. A., & Naliboff, B. D. (2002) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2002.01287.x · Cited by 117 · see citing works
Self-citationHong, S. K., Fan, J., Kemmerer, E. S., Evans, S. J., Li, Y., & Wiley, J. W. (2008) · Gut · doi:10.1136/gut.2008.157594 · Cited by 120 · see citing works
Gut-Brain Axis: Role of Microbiome, Metabolomics, Hormones, and Stress in Mental Health Disorders
Verma, A., Inslicht, S. S., & Bhargava, A. (2024) · Cells · doi:10.3390/cells13171436 · Cited by 133 · see citing works
“Within functional GI disorders like IBS, functional dyspepsia, and chronic constipation or diarrhea, the mal-function of the autonomic nervous system, which directly influences CRF, could contribute to changes in bowel habits and gastric emptying [111].”
BackgroundGarcía‐Ródenas, C. L., Bergonzelli, G. E., Nutten, S., Schumann, A., Cherbut, C., Turini, M., Ornstein, K., Rochat, F., & Corthésy‐Theulaz, I. (2006) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/01.mpg.0000226376.95623.9f · Cited by 114 · see citing works
Sex differences in cannabis withdrawal symptoms among treatment-seeking cannabis users.
Herrmann, E. S., Weerts, E. M., & Vandrey, R. G. (2015) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000053 · Cited by 115 · see citing works
The Effects of Acute and Chronic Psychological Stress on Bladder Function in a Rodent Model
Smith, A. L., Leung, J., Kun, S., Zhang, R., Karagiannides, I., Raz, S., Lee, U. J., Golovatscka, V., Pothoulakis, C., Bradesi, S., et al. (2011) · Urology · doi:10.1016/j.urology.2011.06.041 · Cited by 112 · see citing works
“Fecal pellet output is considered a reliable measure of sacral parasympathetic modulation of colonic motility(19) and previous data suggest this model of chronic WA stress shows excellent face validity for irritable bowel syndrome (which often overlaps with PBS/IC and OAB) with respect to anxiety like behavior, increa…”
BackgroundResultInfluentialSelf-citationDysfunction of stress responsive systems as a risk factor for functional somatic syndromes
Tak, L. M., & Rosmalen, J. G. M. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.12.004 · Cited by 112 · see citing works
“Psychosocial stress is widely believed to be involved in the development of functional somatic syndromes or disorders (FSDs), such as chronic fatigue syndrome (CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS) [1– 3].”
BackgroundPsychological Stress, Intestinal Barrier Dysfunctions, and Autoimmune Disorders: An Overview
Ilchmann-Diounou, H., & Ménard, S. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.01823 · Cited by 117 · see citing works
Ponferrada, Á., Caso, J. R., Alou, L., Rodríguez, A. C., Sevillano, D., Moro, M. Á., Lizasoaín, I., Menchén, P. L., Gómez-Lus, M. L., Lorenzo, P. L., et al. (2007) · Gastroenterology · doi:10.1053/j.gastro.2007.02.032 · Cited by 111 · see citing works
Mechanisms of Stress-induced Visceral Pain
Meerveld, B. G., & Johnson, A. C. (2018) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm17137 · Cited by 109 · see citing works
“Although IBS is not an inflammatory disorder, the immune system plays a role in the pathogenesis of IBS in at least a subset of patients and likely contributes to the etiology of IBS symptoms.22,23 A subset of IBS patients display a low grade chronic inflammation, and there is also evidence that following an enteric i…”
BackgroundInfluentialValdez-Morales, E. E., Overington, J., Guerrero-Alba, R., Ochoa-Cortes, F., Ibeakanma, C. O., Spreadbury, I., Bunnett, N. W., Beyak, M., & Vanner, S. J. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.241 · Cited by 107 · see citing works
Million, M., Grigoriadis, D. E., Sullivan, S., Crowe, P. D., McRoberts, J. A., Zhou, H., Saunders, P. R., Maillot, C., Mayer, E. A., & Taché, Y. (2003) · Brain Research · doi:10.1016/s0006-8993(03)03027-0 · Cited by 107 · see citing works
Self-citationKennedy, P. J., Clarke, G., O‘Neill, A., Groeger, J. A., Quigley, E. M. M., Shanahan, F., Cryan, J. F., & Dinan, T. G. (2014) · Psychological Medicine · doi:10.1017/s0033291713002171 · Cited by 106 · see citing works
“Nonetheless, these results add to the well-acknowledged view that HPA-axis dysfunction is a key feature of IBS (Mayer et al. 2001).”
Childhood functional abdominal pain: mechanisms and management
Korterink, J., Devanarayana, N. M., Rajindrajith, S., Vlieger, A. M., & Benninga, M. A. (2015) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2015.21 · Cited by 106 · see citing works
Hong, J. Y., Kilpatrick, L. A., Labus, J. S., Gupta, A., Jiang, Z., Ashe-McNalley, C., Stains, J., Heendeniya, N., Ebrat, B., Smith, S. E., et al. (2013) · Journal of Neuroscience · doi:10.1523/jneurosci.5733-12.2013 · Cited by 103 · see citing works
“…in visceral perception, in the autonomic nervous system, and in brain responses to visceral stimuli or their expectation have been demonstrated (Mayer et al., 2001; Chang and Heitkemper, 2002; Mayer et al., 2004; Mayer et al., 2005; Mayer et al., 2006; Lieberman et al., 2007; Wang et al.,…”
BackgroundSelf-citationEffect of Yoga in the Therapy of Irritable Bowel Syndrome: A Systematic Review
Schumann, D., Anheyer, D., Lauche, R., Dobos, G. J., Langhorst, J., & Cramer, H. (2016) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2016.04.026 · Cited by 104 · see citing works
Savignac, H. M., Finger, B. C., Pizzo, R., O’Leary, O. F., Dinan, T. G., & Cryan, J. F. (2011) · Neuroscience · doi:10.1016/j.neuroscience.2011.04.054 · Cited by 102 · see citing works
“Abbreviations: IBS, irritable bowel syndrome; SD, social defeat; SD-L, c social defeat-long; SD-S, social defeat-short; SI, social interaction; TPH, tryptophan hydroxylase; 5-HT, serotonin.”
BackgroundInfluentialA Microbial Signature of Psychological Distress in Irritable Bowel Syndrome
Peter, J., Fournier, C., Durdević, M., Knoblich, L., Keip, B., Dejaco, C., Trauner, M. A., & Moser, G. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000630 · Cited by 98 · see citing works
Duloxetine in the treatment of irritable bowel syndrome: an open‐label pilot study
Brennan, B. P., Fogarty, K. V., Roberts, J. L., Reynolds, K. A., Pope, H. G., & Hudson, J. I. (2009) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.1038 · Cited by 100 · see citing works
Boyd, C., Abraham, S., & Kellow, J. (2005) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520510015836 · Cited by 113 · see citing works
The gut microbiota as a key regulator of visceral pain
O’Mahony, S. M., Dinan, T. G., & Cryan, J. F. (2016) · Pain · doi:10.1097/j.pain.0000000000000779 · Cited by 98 · see citing works
Sex‐based differences in gastrointestinal pain
Mayer, E. A., Berman, S. M., Chang, L., & Naliboff, B. D. (2004) · European Journal of Pain · doi:10.1016/j.ejpain.2004.01.006 · Cited by 98 · see citing works
“As discussed above we have recently presented a biobehavioral model which integrates central autonomic, pain modulation, and cognitive mechanisms underlying the symptoms of IBS and other functional disorders (Mayer, 2000; Mayer et al., 2001).”
BackgroundSelf-citationEarly Experience Modifies the Postnatal Assembly of Autonomic Emotional Motor Circuits in Rats
Card, J. P., Levitt, P. R., Gluhovsky, M. Y., & Rinaman, L. (2005) · Journal of Neuroscience · doi:10.1523/jneurosci.2345-05.2005 · Cited by 97 · see citing works
“Autonomic responses to stimuli that elicit fear, anxiety, or other strong emotions typically include significant alterations of autonomic outflow, including gastrointestinal function (Kaplan et al., 1996; Punyabati et al., 2000; Mayer et al., 2001).”
Jarrett, M. E., Burr, R. L., Cain, K. C., Hertig, V., Weisman, P., & Heitkemper, M. M. (2003) · Digestive Diseases and Sciences · doi:10.1023/a:1021904216312 · Cited by 94 · see citing works
Schwetz, I., Bradesi, S., McRoberts, J. A., Sablad, M., Miller, J. C., Zhou, H., Ohning, G., & Mayer, E. A. (2004) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00358.2003 · Cited by 92 · see citing works
Self-citationBraak, B., Klooker, T. K., Wouters, M. M., Welting, O., van der Loos, C. M., Stanisor, O. I., van Diest, S., van den Wijngaard, R. M., & Boeckxstaens, G. E. (2012) · American Journal of Gastroenterology · doi:10.1038/ajg.2012.54 · Cited by 93 · see citing works
Rosztoczy, A. I., Fioramonti, J., Jármay, K., Barreau, F., Wittmann, T., & Bueno, L. P. (2003) · Neurogastroenterology & Motility · doi:10.1046/j.1350-1925.2003.00451.x · Cited by 91 · see citing works
Volatility as a Concept to Understand the Impact of Stress on the Microbiome
Bastiaanssen, T. F. S., Gururajan, A., van de Wouw, M., Moloney, G. M., Ritz, N. L., Long-Smith, C. M., Wiley, N., Murphy, A., Lyte, J. M., Fouhy, F., et al. (2020) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2020.105047 · Cited by 92 · see citing works
Stress-Related Alterations of Visceral Sensation: Animal Models for Irritable Bowel Syndrome Study
Larauche, M. H., Mulak, A., & Taché, Y. (2011) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2011.17.3.213 · Cited by 92 · see citing works
Labus, J. S., Hubbard, C. S., Bueller, J. A., Ebrat, B., Tillisch, K., Chen, M., Stains, J., Dukes, G. E., Kelleher, D. L., Naliboff, B. D., et al. (2013) · Gastroenterology · doi:10.1053/j.gastro.2013.08.016 · Cited by 90 · see citing works
Self-citationCamilleri, M., Kim, D.-Y., McKinzie, S., Kim, H. J., Thomforde, G. M., Burton, D. D., Low, P. A., & Zinsmeister, A. R. (2003) · Clinical Gastroenterology and Hepatology · doi:10.1053/cgh.2003.50019 · Cited by 90 · see citing works
Lane, R., Waldstein, S., Critchley, H., Derbyshire, S., Drossman, D., Wager, T., Schneiderman, N., Chesney, M., Jennings, J., Lovallo, W., et al. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e318198a11f · Cited by 75 · see citing works
- Authors
- Mayer, E. A., Naliboff, B. D., Chang, L., & Coutinho, S. V.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- American Journal of Physiology-Gastrointestinal and Liver Physiology
- Publisher
- American Physiological Society
- Published
- 2001-04-01
- Volume
- 280
- Issue
- 4
- Pages
- G519-G524
- ISSN
- 0193-1857 (ISSN-L)
- 1522-1547
- OpenAlex
- W1869460907
- Cited by
- 413
- References
- 41
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 8 · 2023: 18 · 2022: 10 · 2021: 20 · 2020: 13 · 2019: 8 · 2018: 20 · 2017: 14 · 2016: 21 · 2015: 27 · 2014: 13 · 2013: 15 · 2012: 20
- FWCI
- 14.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Gastrointestinal and Liver Physiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (7r01nr004881-03)
- National Institute of Nursing Research (NR-04881)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-48351, R01DK048351)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR-46122, R01AR046122)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, psychological stress, physical stress, gut-brain axis, autonomic nervous system, neuroendocrine response, visceral pain perception, gastrointestinal motility, gastrointestinal secretion, brain circuits
- MeSH terms
- Animals, Colonic Diseases, Functional, Digestive System, Humans, Stress, Psychological
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