Psychologic factors in peptic ulcer disease and irritable bowel syndrome : a review of the literature on the role of psychologic factors in (two) gastrointestinal diseases

The role psychologic factors play in the aetiology of peptic ulcer disease and the irritable bowel syndrome is discussed on the basis of data from the literature. Although much remains to be established, psychopathology, personality factors, and environmental stress may be involved, in addition to genetic and physiologic factors, in the causation of peptic ulcer disease. However, the role of these psychologic factors is generally not very important, and they do not appear to influence current therapeutic regimens. In the irritable bowel syndrome psychologic factors appear not to be related to the causation of the bowel symptoms. However, psychologic distress and psychiatric disease may induce illness behaviour. In patients with chronic inexplicable bowel symptoms illness behaviour, rather than bowel symptoms per se, frequently prompts patients to seek medical attention. These patients might benefit more from psychiatric therapy than from medical treatment.