Psychological influences on the irritable bowel syndrome.

Irritable bowel syndrome (IBS) is often considered as a purely psychosomatic condition. However, there is now good evidence that it is a multifactorial condition with a whole variety of influences leading to disease expression, of which psychological issues are only one. Nevertheless, addressing psychosocial problems forms an important part of the therapeutic approach to IBS. It is now known that ongoing social stress can make IBS refractory to treatment and there is increasingly firm data to support the notion that antidepressant pharmacotherapy and a variety of behavioural treatments, offer patients with more severe forms of the illness a chance of long-term improvement.