Published online Jun 14, 2014. doi: 10.3748/wjg.v20.i22.6744
Revised: December 19, 2013
Accepted: March 5, 2014
Published online: June 14, 2014
Core tip: Irritable bowel syndrome is a complex, biopsychosocial disorder usually developing under stress, which builds upon hypersensitization, underlined by physiological specificities and heightened neuroticism. Symptom onset is followed by inappropriate cognitive interpretations that can be accompanied by affective disturbances. We consider increased attention to visceral sensation and different manifestations of anxiety to be key components that may lead to symptom exacerbation and perpetuation. This applies to patients who express higher trait neuroticism and are more prone to interpret even mild somatic changes as serious symptoms. An individualized approach is necessary for each patient to estimate current physical and psychological status.