Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 21, 2012; 18(7): 616-626
Published online Feb 21, 2012. doi: 10.3748/wjg.v18.i7.616
Psychosocial determinants of irritable bowel syndrome
Teodora Surdea-Blaga, Adriana Băban, Dan L Dumitrascu
Teodora Surdea-Blaga, Dan L Dumitrascu, 2nd Medical Department, University of Medicine and Pharmacy IuliuHatieganu, Cluj-Napoca 400006, Romania
Adriana Băban, Department of Psychology, Babes-Bolyai University, Cluj-Napoca 400006, Romania
Author contributions: Surdea-Blaga T contributed to the literature search and manuscript writing; Băban A suggested topics to be included and contributed to the writing of the manuscript; and Dumitrascu DL contributed to the study idea, manuscript writing and the final revision of the article.
Supported by The Sectorial Operational Programme Human Resources Development, Contract POSDRU 6/1.5/S/3-, Doctoral studies: through science towards society
Correspondence to: Dan L Dumitrascu, Professor, 2nd Medical Department, University of Medicine and Pharmacy IuliuHatieganu, StrClinicilor 4, Cluj-Napoca 400006, Romania.
Telephone: +40-722-756475 Fax: +40-264-593355
Received: January 17, 2011
Revised: September 22, 2011
Accepted: January 18, 2012
Published online: February 21, 2012

From a pure motor disorder of the bowel, in the past few years, irritable bowel syndrome (IBS) has become a multifactorial disease that implies visceral hypersensitivity, alterations at the level of nervous and humoral communications between the enteric nervous system and the central nervous system, alteration of the gut microflora, an increased intestinal permeability and minimum intestinal inflammation. Psychological and social factors can interfere with the communication between the central and enteric nervous systems, and there is proof that they are involved in the onset of IBS and influence the response to treatment and outcome. There is evidence that abuse history and stressful life events are involved in the onset of functional gastrointestinal disorders. In order to explain clustering of IBS in families, genetic factors and social learning mechanisms have been proposed. The psychological features, such as anxiety, depression as well as the comorbid psychiatric disorders, health beliefs and coping of patients with IBS are discussed in relation to the symptoms and outcome.

Keywords: Anxiety, Depressive symptoms, Irritable bowel syndrome, Personality, Psychosocial factors, Sexual abuse, Stressful events